Pediatric multisystem inflammatory syndrome
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An outbreak of severe Kawasaki-like disease at the Italian epicentre
In the past month we found a 30-fold increased incidence of Kawasaki-like disease. Children diagnosed after the SARS-CoV-2 epidemic began showed evidence of immune response to the virus, were older, had a higher rate of cardiac involvement, and features of MAS. The SARS-CoV-2 epidemic was associated with high incidence of a severe form of Kawasaki disease. A similar outbreak of Kawasaki-like disease is expected in countries involved in the SARS-CoV-2 epidemic...
Despite half a century having passed since Tomisaku Kawasaki first reported his 50 cases in Japan,12 the cause of Kawasaki disease remains unknown. The most accepted hypothesis supports an aberrant response of the immune system to one or more unidentified pathogens in genetically predisposed patients;21, 22, 23 however, the search for the infectious triggers has been disappointing.24 In Japan, during three epidemics recorded in 1979, 1982, and 1986, the highest Kawasaki disease incidence was seen in January, potentially suggesting that factors during winter months may trigger Kawasaki disease.25, 26 In 2010, the incidence of Kawasaki disease in Japan was 239·6 per 100 000 children younger than 5 years, compared with 20·8 per 100 000 in the USA.27 A 2-year retrospective survey done in northeastern Italy calculated an incidence of 14·7 cases per 100 000 children younger than 5 years.28 We report a high number of Kawasaki-like disease cases in the Bergamo province following the SARS-CoV-2 epidemic, with a monthly incidence that is at least 30 times greater than the monthly incidence of the previous 5 years, and has a clear starting point after the first case of COVID-19 was diagnosed in our area. Group 2, diagnosed after SARS-CoV-2 appeared, showed evidence of seroconversion to the virus in the majority of patients.
In the past 20 years, viruses of the coronavirus family have been proposed as possibly implicated in the pathogenesis of Kawasaki disease...
We believe these findings have important implications for public health. The association between SARS-CoV-2 and Kawasaki-like disease should be taken into account when it comes to considering social reintegration policies for the paediatric population. However, the Kawasaki-like disease described here remains a rare condition, probably affecting no more than one in 1000 children exposed to SARS-CoV-2. This estimate is based on the limited data from the case series in this region.
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@jon-nyc said in Pediatric multisystem inflammatory syndrome:
Oh joy.
None of the children who have suffered from a rare inflammatory syndrome caused by COVID-19 in the UK had long-term health problems before falling ill, doctors say.
Between 75 and 100 children are known to have developed the illness, which can cause symptoms similar to sepsis, since the beginning of April.
In adults, many of the coronavirus patients who become most seriously ill are those with other health problems, such as high blood pressure, diabetes or heart disease - dubbed 'underlying health conditions'.
But all the children treated for this inflammatory disease so far had been healthy before they caught the coronavirus, according to Dr Liz Whittaker.
Dr Whittaker is a paediatrician at Imperial College Healthcare in London and has herself treated children with the illness, which has been likened to Kawasaki disease.
She said they are not showing signs of 'typical' COVID-19 infection and it was not obvious why some children were worse affected than others.
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DON’T let them eat cake.
- RFK Jr -
@jon-nyc said in Pediatric multisystem inflammatory syndrome:
A patient account.
Thanks for posting that, Jon. Very informative article, including the plight of this boy at a personal level. Fortunately, happy ending for him, at least so far.
From the article:
"Suspecting he might have a condition like mononucleosis, they prepared to discharge him, thinking he could be safely watched at home with instructions to return if his blood pressure dropped again, his parents said.His mother was urging them to keep Jack longer when his eyes turned red with a “raging case of pinkeye” and rolled back in his head, she said. After a conversation with Jack’s pediatrician, the hospital conducted its own coronavirus test. It was positive."
They sure seem to want people to not stay in the hospital. If they don't really know what's going on, why send him home? They were going to send me home as well, and it's possible that I would have croaked. Fortunately, my wife put up a fuss, so I was admitted, and the rest is, as they say, history.
My point or question, reiterated: why are emergency room docs, or at least some of them, so eager IMO to send a sick person home, when they have more questions than answers as to what is wrong?
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@Rainman said in Pediatric multisystem inflammatory syndrome:
@jon-nyc said in Pediatric multisystem inflammatory syndrome:
A patient account.
Thanks for posting that, Jon. Very informative article, including the plight of this boy at a personal level. Fortunately, happy ending for him, at least so far.
From the article:
"Suspecting he might have a condition like mononucleosis, they prepared to discharge him, thinking he could be safely watched at home with instructions to return if his blood pressure dropped again, his parents said.His mother was urging them to keep Jack longer when his eyes turned red with a “raging case of pinkeye” and rolled back in his head, she said. After a conversation with Jack’s pediatrician, the hospital conducted its own coronavirus test. It was positive."
They sure seem to want people to not stay in the hospital. If they don't really know what's going on, why send him home? They were going to send me home as well, and it's possible that I would have croaked. Fortunately, my wife put up a fuss, so I was admitted, and the rest is, as they say, history.
My point or question, reiterated: why are emergency room docs, or at least some of them, so eager IMO to send a sick person home, when they have more questions than answers as to what is wrong?
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“The good news is that, like Kawasaki disease, almost all the kids are treatable,’’ Schleien said. “It is highly likely that, with treatment, they’re going to be fine. It’s not like the fear of COVID-19 where we know there are no treatments and it’s a matter of luck.’’
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@Loki
My concern is when the public schools open this coming fall. Everything will be fine, until something like the Kawasaki disease hits, then parents will go ballistic.
I did hear a reasonable governor speak to this yesterday. Don't remember who it was. He said that when schools open, if Covid hits, they may have to keep kids home for a couple of weeks. His perspective was that switching from school to online could be a solution parents could get used to.
Problem is, in my experience, most parents will be caught in the scenario where they cannot find daycare that is equivalent to some sort of part-time model. And then once again, the finger pointing will begin. -
@Rainman said in Pediatric multisystem inflammatory syndrome:
@Loki
My concern is when the public schools open this coming fall. Everything will be fine, until something like the Kawasaki disease hits, then parents will go ballistic.
I did hear a reasonable governor speak to this yesterday. Don't remember who it was. He said that when schools open, if Covid hits, they may have to keep kids home for a couple of weeks. His perspective was that switching from school to online could be a solution parents could get used to.
Problem is, in my experience, most parents will be caught in the scenario where they cannot find daycare that is equivalent to some sort of part-time model. And then once again, the finger pointing will begin.Too many one parent families. Too many families where both parents work.
You can't open and close schools like a window shade.
