In the midst of the COVID-19 pandemic, doctors are calling for increased awareness on a new multisystem inflammatory syndrome in children.
Associated with COVID-19, doctors of Kanchi Kamakoti CHILDS Trust Hospital (KKCTH) recently treated an eight-year-old boy with “hyper-inflammatory syndrome”, while another child with similar presentation is improving with treatment at the hospital, doctors say.
The case of the boy was documented and published in Indian Paediatrics . He had fever, cough and throat pain and was admitted to a hospital on day four of illness. He tested negative for SARS-CoV-2.
He continued to have high fever, worsening respiratory symptoms and was referred to KKCTH.
The child had skin rash, cracked lips, fluid retention in limbs and an enlarged abdomen. He was shifted to the paediatric intensive unit. A repeat nasopharyngal swab returned positive for COVID-19.
“We started administering intravenous immunoglobulin and tocilizumab, a drug used in certain rheumatological conditions,” said Bala Ramachandran, head of the department, Intensive Care and Emergency Medicine, KKCTH.
Global alert
Twelve hours later, the boy’s fever spikes settled and inflammatory parameters rapidly decreased. “It is a new condition that we are learning about. It was first reported in the U.K. after which the paediatric intensive care society sent out a warning. Then, a large number of children were admitted in New York and the CDC issued a similar warning,” he said.
S. Balasubramanian, Medical Director of KKCTH, said, “Today, in the midst of COVID-19 pandemic, if any child reports with Kawasaki disease-like presentation, doctors have to think of the possibility of COVID-19 induced hyper-inflammatory syndrome. Paediatricians should start suspecting if a child has fever, rash, abdominal pain, is very ill and has low blood pressure,” he said. This should be kept in mind during the dengue season too, he added.
While COVID-19 is largely benign in children, increasingly this new syndrome affecting children has been identified in Europe and the U.S., A.V. Ramanan, consultant paediatric rheumatologist, Bristol Royal Hospital for Children and Royal National Hospital for Rheumatic Diseases, U.K., said. Some of these children have severe abdominal pain which mimics appendicitis, he added.
