NHS issues high-priority alert to doctors after apparent rise in number of children presenting with problems needing intensive care
A coronavirus-related syndrome among children may be emerging in the UK, according to a high-priority alert issued by the NHS to doctors.
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”, officials 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. 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.
According to the alert, which has also been shared with GPs, 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.
‘Potential emerging links’
The alert, sent on April 25, 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.”
The alert talks about atypical Kawasaki disease, a condition that mainly affects children under the age of five which can’t be prevented. Symptoms include a high temperature that lasts for five days or more, often with a rash and/or swollen glands in the neck. Children can make a full recovery within six to eight weeks if it’s diagnosed and treated promptly, but complications can develop. NHS England stressed there was no confirmed connection between Kawasaki-related diseases and Covid-19.
Professor Simon Kenny, NHS 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.”
Professor Viner 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 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.
Ian Jones, Professor of Virology, University of Reading, said: “We need more data on the suggested link between Covid-19 and a widespread state of hyper-inflammation, especially in children. It’s too early to know if this is a distinct aspect of Covid-19 or, for example, something else noted by the extended confinement with observant parents.”