Health New Covid-19 Disease Affecting Children Better

New Covid-19 Disease Affecting Children Better

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Two studies confirm similarities with Kawasaki disease, but the new syndrome usually affects older children, and triggers more intense inflammation.

Two US studies released on Monday provide a more documented description than before of the symptoms of the mysterious new coronavirus disease that has affected at least a thousand children worldwide, known as multisystem inflammatory syndrome in children (MIS-C).

The two studies, published in the New England Journal of Medicine, are based on nearly 300 children and young people under 21 who had Covid-19 (or strong suspicions), identified in the United States between March and May, at following an alert launched in the United Kingdom at the end of April and then by the American Centers for Disease Prevention and Control (CDC) in May.

A thousand cases have been reported worldwide including these new studies, according to Michael Levin of Imperial College London in an editorial published by NEJM. On May 15, the European Center for Disease Prevention and Control reported 230 cases in Europe, including two deaths in France and the United Kingdom.

As we suspected, it is clear that the syndrome appears in a second time, several weeks after infection with the SARS-CoV-2 virus: a national study suggests twenty-five days of median duration, while the another, in New York, indicates that the majority of cases occurred a month after the peak of the pandemic in the city.

The disease is confirmed as very rare: two cases per 100,000 people under the age of 21. As already observed by doctors on both sides of the Atlantic, black, Hispanic or Indian children are relatively more affected than white children.

Fever, rash, vomiting

The most common symptom is not respiratory: more than 80% of children actually suffered from gastrointestinal complaints (abdominal pain, nausea or vomiting, diarrhea), and many had rashes, especially those under the age of five. All had fever, very often for more than four or five days. And in 80% of them, the cardiovascular system was concerned.

From 8 to 9% of children have developed an aneurysm of the coronary arteries. Most of the children were previously healthy and had no risk factors or pre-existing illnesses. 80% were admitted to intensive care, 20% received invasive respiratory assistance, and 2% died.

At the time of the first alerts, doctors had noted many similarities with Kawasaki disease, which mainly affects infants and very young children and creates inflammation of the blood vessels that can cause heart problems.

These new data confirm that MIS-C and Kawasaki have some things in common, but that the new syndrome generally affects older children, and triggers more intense inflammations.

The mystery remains about the cause of the syndrome, which is believed to be linked to an abnormal immune system response. Clarifying it could have implications for vaccine development and the inflammation also seen in multiple organs in adults with Covid-19, suggests Michael Levin.

Coronavirus

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