Italy and UK to investigate possible link between COVID-19 and childhood inflammatory disease

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MILAN / LONDON (Reuters) – Italian and British medical experts are studying a possible link between the coronavirus pandemic and clusters of severe inflammatory disease in infants arriving at hospital with high fever and swollen arteries.

Scientists work in a laboratory to test COVID-19 samples at the New York Health Service during the coronavirus (COVID-19) outbreak in New York, New York, the United States, on 23 April 2020. Photo taken on April 23, 2020. / Photo taken on November 26, 2018 / REUTERS / Brendan McDermid

Doctors in northern Italy, one of the regions hardest hit by the pandemic, have reported an extraordinarily high number of children under the age of 9 with severe cases of what appears to be Kawasaki disease , more common in parts of Asia.

Doctors in Britain made similar comments, prompting Health Secretary Matt Hancock to say at a coronavirus media briefing on Monday that he was “very concerned” and that medical authorities were examining the matter closely.

A large pediatric company in the United States says it has yet to see something similar.

Kawasaki disease, the cause of which is unknown, often affects children under the age of 5 and is associated with fever, rashes, swollen glands, and in severe cases, inflammation of the arteries of the heart. There is evidence that individuals may inherit a predisposition to the disease, but the pattern is unclear.

England’s national medical director Stephen Powis told the British briefing that he had heard of reports of critically ill children with Kawasaki-like symptoms in the past few days, but stressed that it was too early to determine a link with the coronavirus.

“I have asked the National Clinical Director for Children and Youth to address this matter urgently. … We are not sure yet, ”said Powis.

In Italy, pediatricians are also alarmed.

A hospital in the northern city of Bergamo has recorded more than 20 cases of severe vascular inflammation in the past month, six times more than he would expect in a year, said the pediatric cardiologist Matteo Ciuffreda.

Ciuffreda, of Giovanni XXIII hospital, said that only a few of the infants with vascular inflammation had tested positive for the new coronavirus, but had been told by pediatric cardiologists in Madrid and Lisbon that they had seen similar cases.

He called on colleagues to document all of these cases to determine if there is a correlation between Kawasaki disease and COVID-19. It aims to publish the results of Italian research in a scientific journal.

“MULTI-ORGAN INFLAMMATION”

Ciuffreda said his first apparent case of Kawasaki disease was a 9-year-old boy who arrived at the hospital on March 21, at the height of the coronavirus epidemic, with high fever and low oxygen levels in the blood. He tested negative for the coronavirus.

An analysis showed that the child had an enlarged coronary artery, which is characteristic of severe cases of Kawasaki disease, he said.

“The little boy worried me a lot, with violent multi-organ inflammation affecting both the heart and the lungs,” said Ciuffreda. “I feared he would not survive, but surprisingly, within days, he took a positive turn and got better. “

Sixteen years ago, Kawasaki disease was anecdotally linked to another known coronavirus, although it has never been proven. The research was done after another related coronavirus called NL63 was found in a baby with symptoms of Kawasaki disease in 2004.

Ian Jones, professor of virology at the University of Reading in Britain, said that the NL63 virus uses the same receptor as the new coronavirus to infect humans, but also noted that it was too early to draw conclusions. conclusions.

“We just have to wait and see if it becomes a common sighting,” he said.

The American Academy of Pediatrics (AAP) has yet to see something similar in the United States, which has the highest number of coronavirus infections and deaths. “We are not aware of any reports of this phenomenon in the United States,” Dr. Yvonne Maldonado, who chairs the academy’s committee on infectious diseases, said in an email, referring to a potential link. between COVID-19 and Kawasaki-like symptoms.

Dr. Sean O’Leary, a pediatric infectious disease specialist at Children’s Hospital Colorado who sits on the AAP committee, said his hospital had seen several cases of Kawasaki this year, but none among more than 30 children admitted for COVID- 19.

“Even if it is linked, it is a very rare complication,” he said. “If it were more common, we would already have a pretty good idea of ​​it in the United States. “

Report by Emilio Parodi in Milan and Alisstair Smout in London; Additional reporting by Julie Steenhuysen in Chicago; Editing by Mark Bendeich, Alison Williams and Leslie Adler

Our standards:Principles of the Thomson Reuters Trust.

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