India has started reporting few such cases in the past weeks, but there is no proper data available for diseases like multisystem inflammatory disorder.
Kawasaki disease symptoms among COVID-infected children: There are many things about COVID-19—from its symptoms to vaccines—scientists and doctors across the world are still discovering. Recently children with coronavirus infections have started developing rashes and inflammation, according to some reports. These symptoms are generally found in rare diseases like Kawasaki. Thankfully, other symptoms of Kawasaki disease in these COVID-infected children have not been found.
India has reported such cases in the past few weeks. Such cases started getting reported from the US and Europe in April. The World Health Organization has named it “multisystem inflammatory disorder”.
Kawasaki disease normally affects children. The affected child shows symptoms like red eyes, rashes, and a swollen tongue with reddened lips, and an inflamed blood vessel system all over the body. High fever stays for at least five days. Kawasaki disease also affects coronary functions in the heart.
The reason for Kawasaki disease is not known yet. The Indian Express quoted Dr. Mukesh Agrawal, head of the Paediatrics Department in Mumbai’s KEM Hospital, as saying, “What we do know is that it is an immunological reaction to an infection or a virus.”
Agrawal said in Kawasaki disease, “a child’s immunity system responds to a particular infection” and “develops these symptoms”.
There are very few cases, in which COVID-infected children, two-three weeks after getting infected, have shown symptoms similar to those of Kawasaki disease. COVID-infected children are mostly asymptomatic or with mild symptoms. Few such cases have found in India, including some who tested negative for COVID-19, over the past few weeks, but with some differences.
According to a report in The Indian Express, in June a 14-year-old girl with high fever and rashes admitted to Mumbai’s Kokilaben Dhirubhai Ambani Hospital. She tested positive for COVID-19 and shifted to ICU as her condition was critical. Thankfully, she got discharged after a few days as she recovered.
According to Dr. Tanu Singhal, paediatric infectious disease expert at Kokilaben Dhirubhai Ambani Hospital, she (the patient) had rashes and high fever like Kawasaki, but other symptoms like red eyes and red tongue, etc were absent. Her heart was swollen but coronary functions were not affected like in Kawasaki.
Last month, Singhal treated two other cases in which the children have Kawasaki-like symptoms, but they tested negative for COVID-19.
Though Kawasaki normally affects children below five years of age, adolescents are showing these symptoms in COVID-19 cases. Kawasaki disease typically affects coronary functions but in COVID cases, not all children with Kawasaki-like symptoms have shown such complications; even they all have not developed a strawberry tongue.
According to the Royal College of Paediatricians and Child Health this syndrome shares symptoms with other inflammatory diseases like Kawasaki disease, staphylococcal and streptococcal toxic shock syndromes, bacterial sepsis, and macrophage activation syndromes seen in children. “It can also present with unusual abdominal symptoms,” it says, as reported by The Indian Express.
The Centers for Disease Control and Prevention (CDC), US, said it is still unknown if multisystem inflammatory syndrome is limited to children or if affects adults also.
There is very limited information available now about the risk factors, pathogenesis, clinical course, and treatment for multisystem inflammatory syndrome-C, the CDC added.
What about the treatment then? In the 14-year-old girl case at Kokilaben Dhirubhai Ambani Hospital, the girl was put on steroids to reduce inflammation. The dosage was almost 10 times higher than usual. She was Tocilizumab medicine for COVID-19 management. “Antivirals may not work in such cases,” Dr. Singhal said.