Let’s stop calling it ‘Kawasaki-like’ syndrome

[Redolent]

• The name for the COVID-related illness hitting children is Paediatric Multisystem Inflammatory Syndrome (PMIS). Now that it’s recognised as a separate entity, we can discuss on its own terms.
• Research suggests that symptoms appear 12 weeks after initial infection, six weeks after recovery. So the uptick in cases now result from infection with Coronavirus in February/March
• Initially seemed to affect the under 5s; now it appears to be 5-18 year olds.

Up to last week, this was barely on our radar. Now it’s being increasingly reported. With the huge time lag between infection with Coronavirus and onset of MCIS, it seems wise to not simply dismiss Covid in children as ultimately benign (guilty of doing this myself).

I hope this is is somewhere we can discuss and share links. Will post some below.

Combination of genes and environment similar with higher risk for Covid with BAME perhaps

They need to investigate that link don't they- I feel for people in high risk BAME categories now it seems children in those groups also at higher risk of complications

Yes obviously they are, also read somewhere children who are obese are more susceptible.

One council, (Somerset?) has already given BAME workers vulnerable status and increased protection in terms of PPE etc. I hope this kind of thing extends nationwide

Oh yay. Something new for me to worry about. Daughter (6) had suspected Covid back along in March (very nasty cough, high temperature, breathlessness) and just this weekend started complaining of stinging eyes and tummy aches.

Have just given her a good check over and no rash, normal eyes and no temperature (plus she's bouncing around like Tigger on speed) so I reckon she's ok... but... I'm going to be keeping an eagle eye on her.

Thank you for sharing as I hadn't heard of this.

It’s still so very rare but it’s good to know, as if it is caught in time and the right medical treatment is given, 99.9% is a good outcome.

What I want to know is whether my child with a vsd (hole in the heart) is at increased risk of developing these complications or at increased risk of a bad outcome if they develop it. I haven’t been able to find any information about this at all!

I’m not desperately worried, from a cardiac perspective she is fine, but knowing the risk will inform decisions on return to school etc

I don’t think this should be a reason not to open schools as it’s so rare but the media seem keen to flog this to death to whip parents up into a frenzy.

@TheHarryFormerlyKnownAsPrince that’s so hard to answer, the only comfort is it is so rare and if treatment is given early enough it is a good outcome sorry it’s such a worrying time for you.

Diabetes is more common in children in BAME population in Bradford which is a Covid hit area...

diabetestimes.co.uk/bradford-deemed-type-2-diabetes-hotspot-among-children/

It seems ethnic minorities not only develop diabetes in adults at a lower weight, but also at younger ages too

I watched a documentary on this last year, it was really sad young children of about ten with type 2...

The diabetes documentary was on the "Born in Bradford' study by the BBC here is anyone is interested

www.bbc.co.uk/programmes/m0009kt4

"In this programme Winifred follows researchers trying to determine why the city is seeing an increase in type 2 diabetes in youngsters.

When Consultant Paediatrician Matthew Mathai first started work in the city eleven years ago it was rare to see children with type 2 diabetes and yet, today, he and his team are facing rising numbers of cases and have fears that there are many more that are in a pre-diabetic state and not receiving the interventions that might help them."

TheHarryFormerlyKnownAsPrince my dd has ARCA her cardiology team at GOSH can't say if she is more at risk or not, her brother had Covid a few weeks ago ,it was an anxious time worrying if she would get it too.

An ever-changing picture.

This might not be so relevant now but this was my source of info www.medrxiv.org/content/10.1101/2020.05.10.20097394v1 - Kawasaki Disease outbreak in France.
17 children admitted in an 11 day period between 27th April and 7th May 2020.

" ..Their median age was 7.5 (range, 3.7-16.6) years, and 59% of patients originated from sub-Saharan Africa or Caribbean islands...

Conclusions: The ongoing outbreak of KD in the Paris might be related to SARS-CoV2, and shows an unusually high proportion of children with gastrointestinal involvement, KDSS and African ancestry"

From the France study (ThumbWitch)

KDSS= Kawasaki Disease Shock Syndrome

@RigaBalsam There are about 12 million under 18s in the UK. If the estimate from the Lancet of 1 in 1000 children who have had COVID-19 develop the syndrome, that would be 12,000 with 100% infection rate. That's 9600 if 80% of the population is infected. Based on an estimate of 25% of the population already having been infected, that would mean we should expect 3000 cases over the coming weeks.

That's all very hypothetical though, especially as the estimate in the Lancet is based on very little data. It also seems that although it effects children of all ages, it seems to be mostly toddlers so the risk is not the same for different age groups. There also seems to be a link to ethnicity, so again the risk is not equal.

The risk for a BAME 2 year old is probably much higher than 1 in 1000, a caucasian teenager, much less. I do think the government ought to be rethinking their return to school plans in light of this. particularly as Year R/1 are the age group most likely to have toddler siblings.

Some stuff on vitamin D might of interest too

bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1438-2
Breastfeeding and vitamin D supplementation reduce the risk of Kawasaki disease in a German population-based case-control study

ard.bmj.com/content/74/Suppl_2/843.1
Severe Vitamin D Deficiency in Patients with Kawasaki Disease: its Possible Role in the Risk to Develop Coronary Artery Damage

Thanks for your post going.

It is worth repeating that there are less cases in the UK than usual.

@goingoverground this syndrome actually can effect older children, it’s slightly different to Kawasaki

It was a 14 year old Asian child that died of it first in the UK.

www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31094-1/fulltext

Every child is either black/African/Caribbean or Asian

I know it affects older children, I didn't say it didn't, @Alex50. But if you look at worldwide cases, there is a higher incidence in younger children and BAME children. The risk is not equal for all children.

Just as an illustration (this is not fact), if 1 in 1000 children in the UK develop PIMS after exposure to SARS-Cov-2 but all those children are BAME, that would mean the risk to non BAME children is zero but the risk to BAME children is actually 1 in 200 (based on an approximation of 20% of the population under 18 being BAME).

I had Kawasaki disease as a child. Diagnosed and treated on Day 8. Very lucky. Took doctors a while to diagnose me as they hadn't seen it before.

I am convinced I had Coronavirus beginning of March, along with my son. He is under 1 and I am terrified of him getting this illness.

Everytime I hear Kawasaki disease it sends me into a panic.