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Emergence of an inflammatory disease potentially related to COVID-19

by Maxime Dubé - August 13, 2020   958 Views   4 min
Emergence of an inflammatory disease potentially related to COVID-19

Claim

A new inflammatory disease has emerged in children that may be related to COVID-19

Verdict

Accurate as a whole (with reservations)

An article on Yahoo News reports a potential link between a childhood inflammatory disease reported in Europe and North America and COVID-19. It is indeed accurate that a link between an inflammatory disease in children and COVID-19 is currently suspected, but it has not yet been formally proven.

What is the Pediatric Multisystemic Inflammatory Syndrome?

The World Health Organization (WHO) reports that intensive care units in North America and Europe have recently been noticing the development of Kawasaki-like inflammatory disease and toxic shock in children and adolescents. According to the Mayo Clinic, Kawasaki disease causes inflammation in children that results in swelling, redness and pain that can lead to failure of several organs such as the heart, blood vessels, kidneys, digestive system, brain, skin or eyes.

Is there a link to COVID-19?

The sudden onset of this disease in the middle of the COVID-19 pandemic raises suspicions of a possible link between the two. WHO reports that in the majority of cases, patients with pediatric multisystemic inflammatory syndrome had already contracted COVID-19, according to antibodies revealed in serological tests. A Canadian Paediatric Society blog post advances that this new inflammatory disease could be a delayed immune system response to COVID-19. The post adds that it would not be surprising for the new syndrome to be an unusual response to this new virus, just as the Kawasaki disease is an unusual immune system response to certain diseases.

However, as indicated in a literature review by the Institut national d'excellence en santé et en services sociaux du Québec (INESSS), the number of reported cases of this disease remains low and several methodological problems make it difficult to establish a causal link. Indeed, the data on which this hypothesis is based is drawn from clinical observations and not from peer-reviewed, controlled research. Therefore, it is difficult to determine whether other factors are at play when the history and infectious profile of patients are not known and controlled.

The same finding was made by the European Centre for Disease Prevention and Control (ECDC), which in a rapid risk assessment document conducted an analysis of the limited data available to date to assess the potential for causality between COVID-19 and the syndrome using Bradford Hill's nine causality criteria. Only five of the nine causality criteria were met. Therefore, the ECDC indicates that further clinical studies are needed to further establish causal links between the two diseases.

What are the signs and treatments for the disease?

In general terms, the Canadian Paediatric Society indicates that the syndrome begins with a fever lasting more than 3 days and continues with a significant drop in energy, conjunctivitis, rash, swelling and cracking of the hands, feet or lips. In some cases, severe stomach pain and diarrhea may occur.

This clinical manifestation occurs between 1 to 6 weeks after infection with COVID-19, and may also occur in conjunction with respiratory symptoms. Its presentation is similar to a classic presentation of Kawasaki disease. However, the cases described do not correspond to the ethnicity typically represented in patients with Kawasaki disease (more Caucasian cases). Currently, therefore, it is not possible to conclude that this post-infectious inflammatory syndrome is present only in the pediatric population.

If your child exhibits such symptoms, it is strongly recommended that you contact your health care provider.

Once at the hospital, doctors will analyze the symptoms and, if necessary, take blood samples, a nasal swab and an echocardiogram to establish the presence of the syndrome.

Treatments are similar to those used in the case of Kawasaki disease, with doctors prescribing immunoglobulins and aspirin or even steroids until the symptoms subside.

What can be done to protect children?

Since we don't know the real causes of the disease and the only existing lead is related to COVID-19, the Centers for Disease Control and Prevention advises following the prevention measures used for COVID-19. According to WHO, these include frequent hand washing with soap or water-based gel, maintaining a distance of at least one meter from other people, wearing a mask when physical distancing is not possible (except for children under 2 years old), sneezing into one's elbow, and avoiding touching one's eyes, nose and mouth. It is important to remember that children are no less likely to get the disease and that they too should follow health instructions, even though they are less likely to get severe forms of COVID-19 than the elderly and even though pediatric multisystemic inflammatory syndrome is still rare. In addition, it must be remembered that children can also infect other people, including the elderly.

To learn more about how children can transmit the virus : https://www.covid19facts.ca/en/fact-checked/the-claim-that-children-cannot-catch-or-transmit-the-covid-19-virus-is-inaccurate

It should be noted that the instructions from health authorities may change as new studies on this new disease emerge.

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  Claim

Yahoo!

Organization
A new inflammatory disease has emerged in children that may be related to COVID-19

Verdict:

Accurate as a whole (with reservations)

 August 13, 2020


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