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Italian Hospital Sees 30-Fold Increase In Children Admitted For Rare Inflammatory Condition

Discussion in 'Pediatrics' started by Mahmoud Abudeif, May 14, 2020.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    A new analysis suggests the rare inflammatory condition increasingly being seen in young children is in fact linked to the novel coronavirus.

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    Researchers in Lombardy, Italy - the epicenter of the country's outbreak - looked at 10 pediatric cases with symptoms such as a full body rash and swollen hands and feet.

    By comparison, over the last five years, just 19 children were admitted to the ER with the symptoms which resembled Kawasaki Disease.

    The team says the admissions for these symptoms over the last two months is a 30-fold increase from what it normally sees.

    What's more, 80 percent of the children admitted to the hospital this year tested positive for coronavirus antibodies and 60 percent had more severe complications such as heart issues.

    Cases of these rare inflammatory illnesses in children were first reported in Britain, Italy and Spain.

    The syndrome resembles Kawasaki Disease, a condition that causes inflammation in the walls of the blood vessels and affects mostly children under five years old.

    It's not known what triggers the condition, but it is believed to be an immune system overreaction to an infection.

    The new disorder, dubbed 'Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19,' can attack multiple organs, impair heart function and weaken heart arteries.

    In the Bergamo province, where Lombardy is located, only 19 children were diagnosed with Kawasaki Disease over the last five years.

    However, between February 18 and April 20 of this year, there were at least 10 cases in children with the emerging syndrome - suggesting as much as a 30-fold increase.

    'We noticed an increase in the number of children being referred to our hospital with an inflammatory condition similar to Kawasaki Disease around the time the SARS-CoV-2 outbreak was taking hold in our region,' said co-author Dr Lucio Verdoni, a pediatric rheumatologist at Hospital Papa Giovanni XXIII in Bergamo, Italy.

    'Although this complication remains very rare, our study provides further evidence on how the virus may be affecting children.

    'Parents should follow local medical advice and seek medical attention immediately if their child is unwell. Most children will make a complete recovery if they receive appropriate hospital care.'

    For the study, published in The Lancet, the team looked at 29 children admitted to the hospital's pediatric unit with symptoms of Kawasaki Disease from January 1, 2015 to April 20, 2020.

    Prior to the coronavirus pandemic, doctors were treating one case of Kawasaki Disease approximately every three months.

    Researchers say the increase from 19 children over five years (2015 to 2019) to 10 children over two months (February 2020 to April 2020) was not due to an increase in hospital admissions.

    Children who were admitted to the hospital with symptoms after February 18 were generally older than children from the previous five years, seven-and-half years old compared to three years old.

    They also had more serious symptoms such as heart complications in 60 percent and signs of toxic shock syndrome in 50 percent.

    Patients both before and after the coronavirus outbreak were treated with immunoglobulin, but 80 percent of children during the outbreak also needed steroids, compared to 16 percent from before the pandemic.

    Most importantly, of those 10 children, eight of tested positive for COVID-19 antibodies.

    The authors this is evidence there is a link between the virus and the inflammatory condition and that it should be classified as 'Kawasaki-like Disease.'

    'We are starting to see case reports of children presenting at hospital with signs of Kawasaki Disease in other areas hit hard by the COVID-19 pandemic, including New York and South East England,' said lead author Dr Lorezno D'Antiga, a pediatrician at Papa Giovanni.

    'Our study provides the first clear evidence of a link between SARS-CoV-2 infection and this inflammatory condition, and we hope it will help doctors around the world as we try to get to grips with this unknown virus.'

    The study comes on the heels of new that 15 US states are looking into cases of a rare inflammatory syndrome mainly affecting children and believed to be linked to the novel coronavirus, New York Governor Andrew Cuomo said on Wednesday.

    Cuomo told reporters at a press conference that state health officials are investigating 102 cases, including dozens of hospitalizations.

    So far, three children in New York have died from the condition, including a five-year-old boy, a seven-year-old boy and an 18-year-old woman.

    Now, 14 other states, including California, Connecticut and Massachusetts, have reported cases.

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