Doctors in Britain, Italy, and Spain have been warned to look out for a rare inflammatory condition in children that is possibly linked to the new coronavirus.
Earlier this week, Britain’s Paediatric Intensive Care Society issued an alert to doctors noting that, in the past three weeks, there has been an increase in the number of children with “a multi-system inflammatory state requiring intensive care” across the country. The group said there was “growing concern” that either a COVID-19 related syndrome was emerging in children or that a different, unidentified disease might be responsible.
“We already know that a very small number of children can become severely ill with COVID-19 but this is very rare,” said Dr Russell Viner, president of the Royal College of Paediatrics and Child Health. He said the syndrome was likely caused by an overreaction of the body’s immune system and noted similar symptoms had been seen in some adults infected with the coronavirus.
The cases were also reported to have features of toxic shock syndrome or Kawasaki disease, a rare blood vessel disorder. Only some of the children tested positive for COVID-19, so scientists are unsure if these rare symptoms are caused by the new coronavirus or by something else. Health officials estimate there have been about 10-20 such cases in Britain and NHS England said it is urgently investigating the reports.
Viner said that although doctors were considering other potential causes for the syndrome, including other viruses or new medications, “the working hypothesis is that it’s COVID-related.”
Spain’s Association of Pediatrics recently made a similar warning, telling doctors that in recent weeks, there had been a number of school-age children suffering from “an unusual picture of abdominal pain, accompanied by gastrointestinal symptoms” that could lead within hours to shock, low blood pressure and heart problems.
“It is a priority to recognize these (symptoms) to urgently refer these patients to a hospital,” the pediatric association said.
In Italy, Dr Angelo Ravelli of Gaslini Hospital and a member of the Italian Paediatricians’ Society, sent a note to 10,000 colleagues raising his concerns. He and his team reported an unusual increase in the number of patients with Kawasaki disease in regions of Italy hit hard by the pandemic, noting some children had COVID-19 or had contacts with confirmed virus cases.
“These children do not respond to traditional treatment,” he said, adding that some were given a high dose of steroids. Those who developed toxic shock syndrome needed help breathing and were admitted to intensive care units, Ravelli said.
Kawasaki symptoms include a high temperature that lasts for 5 days or more, a rash and swollen glands in the neck, according to Britain’s National Health Service.
Dr James Gill, an honorary clinical lecturer at Warwick Medical School, said while the reports were concerning there was still no solid evidence that the rare syndrome was caused by COVID-19.
“Regardless of the source, multi-system inflammatory diseases are exceptionally serious for children and already stretched intensive care teams, so keeping an extra eye out for new symptoms arising in the patients we see is always a good thing,” he said.
Some possible cases have also been reported in France and Belgium.
Dr Sonja Rasmussen, a University of Florida paediatrics professor, noted one similar case in the United States involving a 6-month old girl in California who was diagnosed with Kawasaki disease and then COVID-19. That report, from Stanford University, doesn’t clarify whether both illnesses happened coincidentally or if COVID-19 might have somehow caused Kawasaki disease, said Rasmussen, who co-authored a recent JAMA Pediatrics article about COVID-19 and children.
“We’ll need more information published in the peer-reviewed literature to better understand this association. However, Kawasaki disease is a relatively rare condition, so seeing these cases makes us concerned that Kawasaki disease could be a rare complication of COVID-19,” she said. “We need to remain vigilant when we see children with findings that aren’t typical for COVID-19.”
To date, children have been among the least affected group by the coronavirus. Data from more than 75,000 cases in China showed they comprised 2.4 percent of all cases and mostly suffered only mild symptoms.
The World Health Organization said it was attempting to gather more information on any new, coronavirus-related syndrome in children from its global network of doctors but had not received any official reports about it.
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U.N. Secretary-General Antonio Guterres challenged leaders Tuesday to use the coronavirus pandemic to “rebuild our world for the better” by also working together to tackle other global threats such as climate change.
The outbreak has resulted in at least 200,000 deaths globally and widespread economic hardship as countries impose lockdowns to prevent the spread of the virus.
“It has exposed the fragility of our societies and economies to shocks,” the United Nations chief said, adding that “the only answer is brave, visionary and collaborative leadership.”
“The same leadership is needed to address the looming existential threat of climate disruption,” Guterres, noting that the past decade was the hottest in history since measurements began.
Speaking by video link at a two-day international conference on global warming, Guterres warned that the cost of inaction on climate change would be immense, but said that “technology is on our side.”
“These are dark days, but they are not without hope,” Guterres said. “We have a rare and short window of opportunity to rebuild our world for the better.”
“Let us use the pandemic recovery to provide a foundation for a safe, healthy, inclusive and more resilient world for all people,” he added.
The U.N. chief called on all countries to commit to pumping no more carbon dioxide — the main greenhouse gas — into the atmosphere by 2050 and proposed a six-point plan to ensure climate change features prominently in government efforts to recover from the pandemic.
The steps proposed by Guterres include making sure that trillions in stimulus spending boost green jobs and sustainable businesses
“Where taxpayers’ money is used to rescue businesses, it must be creating green jobs and sustainable and inclusive growth,” he said. “It must not be bailing out outdated, polluting, carbon-intensive industries.”
This includes ending fossil fuel subsidies and making sure that polluters pay for the damage they cause, he said.
The French government is requiring companies that receive state bailouts to use the money to become more environmentally sustainable. But climate campaigners have noted that recipients include national carrier Air France, which is reopening domestic routes to cities that also have high-speed rail connections.
The U.N. chief warned that just like the pandemic, climate change can’t be tackled by anyone nation on its own.
“Like the coronavirus, greenhouse gases respect no boundaries,” said Guterres. “Isolation is a trap. No country can succeed alone.”
Together, the Group of 20 major developed and emerging economies accounts for more than 80 percent of global emissions, Guterres said.
“The Paris Agreement was largely made possible by the engagement of the United States and China,” he said. “Without the contribution of the big emitters, all our efforts will be doomed.”
Scientists have warned that there’s little time left if the world wants to achieve the headline goal of the 2015 Paris climate accord — keeping global warming well below 2 degrees Celsius, ideally 1.5 C. Under President Donald Trump, the U.S. has moved to withdraw from the agreement.
Guterres also urged the European Union to show “global leadership” by presenting updated emissions reduction plans by the end of the year that would put it on course to become the first climate-neutral continent by 2050.
German Chancellor Angela Merkel indicated Tuesday that her country was willing to support a more ambitious emissions reduction target for the EU by 2030, from 40 percent at the moment to as much as 55 percent. Such an increase would likely require Germany, which has Europe’s biggest economy, to make even steeper cuts nationally to balance out lower reductions by other countries in the bloc.
She cautioned that the drop in emissions likely seen due to the pandemic ’s effect on the global economy would be temporary and shouldn’t prompt countries to lessen their efforts to cut greenhouse gases.
Merkel’s speech to the annual Petersberg Climate Dialogue was beset by technical difficulties at the start. Another planned speaker, British Prime Minister Boris Johnson, didn’t attend after recently falling ill with COVID-19. He returned to work Monday.
Johnson’s deputy, Foreign Secretary Dominic Raab, told participants by video link from London that when the threat from coronavirus recedes “it will be the duty of every responsible government to see that our economies are revived and rebuilt in a way that will stand the test of time.”
“That means investing in industries and infrastructure that can turn the tide on climate change,” he said. “And it means doing all we can to boost resilience by shaping economies that can withstand everything that nature throws at us.”
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