Selasa, 28 April 2020

Dozen children have needed intensive care due to ‘mystery new coronavirus-linked condition’ - The Sun


MORE than a dozen children have reportedly needed intensive care due to a "mysterious new coronavirus-linked condition".

The youngsters had all fallen ill with a potentially fatal combination of symptoms similar to toxic shock syndrome.

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 Doctors say the syndrome is similar to toxic shock syndrome and Kawasaki disease, which can cause redness of the tongue
Doctors say the syndrome is similar to toxic shock syndrome and Kawasaki disease, which can cause redness of the tongueCredit: Shutterstock
 The symptoms of the mysterious condition include rashes
The symptoms of the mysterious condition include rashesCredit: Shutterstock

According to the Guardian, at least one child had to be put onto an extra corporeal membrane oxygenation (ECMO) machine - an aggressive form of life support.

These are seen as a "last resort" treatment and the prognosis for those who end up on an ECMO machine is, by definition, poor.

A number of other kids admitted to intensive care also needed treatment for heart inflammation.

NHS bosses are so concerned that they sent an urgent alert to doctors warning of a rise in cases in recent weeks.

They warned that the cases have features of toxic shock syndrome and Kawasaki disease, an inflammatory condition that attacks blood vessels and the heart.

These conditions can cause harmful internal swelling, fever and breathing problems - which are all also the main symptoms of coronavirus.

Some also reported suffering from abdominal pain and gastrointestinal symptoms, like vomiting and diarrhoea, as well as heart problems.

Dr Liz Whittaker, a consultant at St Mary’s hospital in London and a member of the Royal College of Paediatrics and Child Health’s allergy, immunology and infectious diseases committee told the Guardian: “Our worry is that paediatricians who see children with fever and abdominal pain will do blood tests to look for problems such as appendicitis, but might not do bloods that look for inflammatory issues."

'Plausible link'

Professor Stephen Powis said it was "too early to say" whether there is a link between the Kawasaki-like disease and coronavirus.

But chief medical officer Prof Chris Whitty said it was "entirely plausible".

They have instructed medical experts to look into the potential link as a "matter of urgency".

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It comes after the UK Paediatric Intensive Care Society (PICS) tweeted an alert it said was from NHS England which says in the "last three weeks, there has been an apparent rise in the number of children of all ages presenting with a multi-system inflammatory state requiring intensive care across London and also in other regions of the UK".

NHS England confirmed it had shared the warning through its incident teams to clinical commissioning groups and hospital trusts.

The alert said the effects had been seen in children both with and without Covid-19 but there was evidence that some patients had had coronavirus previously.

Mr Hancock said he was "very worried" about reports of a new illness in children and experts are "looking into it with great urgency".

 The Paediatric Intensive Care Society (PICS) published this message on Twitter last night
The Paediatric Intensive Care Society (PICS) published this message on Twitter last night

SIGNS TO WATCH OUT FOR

NHS doctors have been told to watch out for signs of an 'inflammatory syndrome' in kids, after a rise in cases of the new condition.

Health chiefs said in an alert to GPs the signs include:

  • stomach pain
  • gastrointestinal symptoms - like vomiting and diarrhoea

The mysterious condition has been compared to toxic shock syndrome and Kawasaki disease.

The signs of TSS are:

  • high temperature
  • flu-like symptoms, like headache, feeling cold, aches, sore throat and cough
  • feeling and being sick
  • diarrhoea
  • widespread burn-like rash
  • lips, tongue, and whites of the eyes turning bright red
  • dizziness or fainting
  • difficulty breathing
  • confusion

Signs of Kawaski disease include:

  • a rash
  • swollen glands in the neck
  • dry, cracked lips
  • red fingers or toes
  • red eyes

He told LBC: "We put out at the weekend a call across the NHS because some cases of this had been identified and then this call essentially says to doctors in other parts of the country 'have you seen this condition?' and then they collate the information and find out what's going on."

He said: "We have lost some children," adding: "There are some children who have died who didn't have underlying health conditions."

The Health Secretary explained: "It's a fresh, new disease that we think may be caused by coronavirus and the Covid-19 virus.

"We're not 100 per cent sure because some of the people who got it hadn't tested positive.

"We're doing a lot of research now but it is something we're worried about.

"What I would also stress is that it is rare.

"Although it is very significant for those children who do get it the number of cases is small."

Speaking at the daily Downing Street press conference last night, Professor Stephen Powis said: "We have become aware in the last few days of reports of severe illness in children which might be a Kawasaki-like disease.

"Both Chris (Whitty) and I are aware of that, and we have asked our experts, I have asked the national clinical director for children and young people to look into this as a matter of urgency."

He urged parents who are worried about a child who is sick and not recovering to seek medical help.

Prof Whitty added: "This is a very rare situation but I think it is entirely plausible that this is caused by this virus, at least in some cases.

"Because we know that in adults who of course have much more disease than children do, big problems are caused by an inflammatory process and this looks rather like an inflammatory process, a rather different one.

"Therefore, given that we have got a new presentation of this at a time with a new disease, the possibility - it is not a definite, we need to look for other causes as well - but the possibility that there is a link is certainly plausible."

Bizarre symptoms

According to the alert, which was originally shared with GPs in north London, children affected display signs similar to toxic shock syndrome (TSS), a severe illness associated with infections, and have blood markers in line with severe Covid-19 in children.

They may also have abdominal pain and symptoms of inflammation around the heart.

The alert says: "There is a growing concern that a Sars CoV-2 (Covid-19) related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases."

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The alert talks about atypical Kawasaki disease, a condition that mainly affects children under the age of five.

Symptoms include a high temperature that lasts for five days or more, often with a rash and/or swollen glands in the neck.

NHS England stressed there was no confirmed connection between Kawasaki-related diseases and Covid-19.

Professor Simon Kenny, the NHS's national clinical director for children and young people, said: "Thankfully Kawasaki-like diseases are very rare, as currently are serious complications in children related to Covid-19, but it is important that clinicians are made aware of any potential emerging links so that they are able to give children and young people the right care fast.

"The advice to parents remains the same: if you are worried about your child for whatever reason, contact NHS 111 or your family doctor for urgent advice, or 999 in an emergency, and if a professional tells you to go to hospital, please go to hospital."

Rare cases

Professor Russell Viner, president of the Royal College of Paediatrics and Child Health (RCPCH), said parents should be reassured that children are unlikely to be seriously ill with Covid-19.

He said: "We already know that a very small number of children can become severely ill with Covid-19 but this is very rare - evidence from throughout the world shows us that children appear to be the part of the population least affected by this infection.

"New diseases may present in ways that surprise us, and clinicians need to be made aware of any emerging evidence of particular symptoms or of underlying conditions which could make a patient more vulnerable to the virus.

"However, our advice remains the same: parents should be reassured that children are unlikely to be seriously ill with Covid-19 but if they are concerned about their children's health for any reason, they should seek help from a health professional."

According to the NHS, children are contracting Covid-19 at the same rate as adults but are suffering less severe symptoms on the whole.

However, children have died, including 13-year-old Ismail Mohamed Abdulwahab, from Brixton, south London, who died in King's College Hospital at the end of March.

The latest figures for hospital deaths of patients testing positive for Covid-19 in England show that up to 5pm on April 25 there had been nine deaths between the ages of 0 and 19.

This represents 0.05 per cent of all hospital deaths in England.

In Scotland, no Covid-19 deaths had been registered by April 19 for people aged 0-14. In Northern Ireland, no Covid-19 deaths had been registered by April 17 for people aged 0-14.

Chris Whitty and Stephen Powis on link between coronavirus and cases of 'inflammatory syndrome' in children

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2020-04-28 09:23:16Z
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