Coronavirus-related syndrome among children may be emerging, alert suggests

A coronavirus-related syndrome among children may be emerging in the UK, a health alert sent to doctors suggests.

The UK Paediatric Intensive Care Society (Pics) tweeted an alert which 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”.

It said the effects had been seen in children both with and without coronavirus 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 was reportedly 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.”

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.”

Prof 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.

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

“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% 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.

Pics said its tweet had been meant for health professionals and urged parents not to worry.

A statement added: “Over the weekend, Pics members received an email alert from NHS England highlighting a small rise in the number of cases of critically ill children presenting with an unusual clinical picture.

“Many of these children had tested positive for Covid-19, while some had not.

“It is important to highlight that, both in the UK and in other countries, there have still been very few cases of critically unwell children with Covid-19 admitted to paediatric intensive care units.

“However, an early case report relating to Covid-19 presenting as Kawasaki syndrome has been published recently, and Pics is aware of a small number of children nationally who appear to fit the clinical picture described in the NHS England alert.”