New Syndrome in Children

COVID – 19, Thursday 14th May

Paediatric Multisystem Inflammatory Syndrome

Cases in the US, Spain, Italy, France, Netherlands, but not China

Most of the children tested negative for coronavirus, but tested positive for detection of antibodies

Children, up to 6-week delay

US
https://edition.cnn.com/2020/05/14/health/pediatric-coronavirus-syndrome-multisystem-health/index.html

https://discoveries.childrenshospital.org/covid-19-inflammatory-syndrome-children/

https://www.medscape.com/viewarticle/930223

Doctors are investigating cases in at least 150 children, most of them in New York

CNN survey
17 states have suspected cases

Dr Burns Boston Children’s Hospital;

‘This multisystem inflammatory syndrome is not directly caused by the virus’

‘The leading hypothesis is that it is due to the immune response of the patient’
UK
https://www.bbc.co.uk/news/health-52648557

https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/covid_inflammatory_condition.aspx

Up to 100 children affected

Some have needed intensive care while others recovered quickly

Clinical features
High fever
Rash
Red eyes
Swelling
Abdominal pain
Diarrhoea or vomiting
Confused or overly sleepy
General pain
Renal or cardiac involvement

Evidence of blood vessel inflammation;
Red eyes
Bright red tongue
Cracked lips

Early treatment to prevent organ damage
Children with the presentation appear to be responding well to intravenous immunoglobulin and/or steroids.

Hyperinflammatory shock in children during COVID-19 pandemic, The Lancet

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)31094-1.pdf

South Thames Retrieval Service, 2 million children
10 days in mid April, 2020, 8 children
National alert
All children were previously fit and well
6 out of 8 were of Afro-Caribbean descent
5 out of 8 were boys

Clinical presentations
Unrelenting fever (38–40°C)
Variable rash
Conjunctivitis
Peripheral oedema
Generalised extremity pain
Significant gastrointestinal symptoms

All progressed to warm, vasoplegic shock

Refractory to volume resuscitation

Eventually requiring noradrenaline and milrinone for haemodynamic support

Most of the children had no significant respiratory involvement

Pleural, pericardial, and ascitic effusions, suggestive of a diffuse inflammatory process.

All children tested negative for severe acute respiratory syndrome coronavirus 2

No pathological organism was identified in seven of the children

Adenovirus and enterovirus were isolated in one child.

Inflamed coronary arteries

One death from a large cerebrovascular infarct

A new phenomenon affecting previously asymptomatic children with SARS-CoV-2 infection
Multifaceted nature of the disease
epidemic: an observational cohort stud
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31103-X/fulltext

Видео New Syndrome in Children канала Dr. John Campbell