Rare Inflammatory Syndrome in Kids with COVID-19 Save
Pediatricians are asking the question - could this be a rare manifestation of COVID-19 in children?
There are now 3 case reports in the U.S of children infected with the coronavirus who have developed what looks like Kawasaki's diseaes. Simimar reports have been seen in the UK, Italy and Spain.
This rare syndrome has been described from 3 children (age from 6 months to 8 years) treated at Columbia University Medical Center in New York, who manifest fever, abdominal pain and gastrointestinal symptoms and evidence of cardiac inflammation.
A similar report from Stanford University describes a 6-month-old was admitted to the hospital with Kawasaki disease and was later diagnosed with COVID-19, the illness caused by the new coronavirus. Interesting as Kawasaki disease has long been postulate to be a post infectious disorder.
In the UK, the National Health Service reports a small number of cases of critically ill children with overlapping features of toxic shock syndrome and atypical Kawasaki disease who happen to be Covid-19 positive.
These reports are unusual as children appear to be much less affected by COVID-19 cases and there are very few with severe disesase.
Dr. Jane Burns, director of the Kawasaki Disease Research Center at the University of California San Diego, said it is unclear if the cases reported to date are related to COVID-19.
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These cases would make one to associate with many of the acro-ischemic lesions, as observed by many Italian Dermatologists who worked front line on Covid 19 fight, and they postulate as vasculitis; as those are more than viral exanthema and seemingly also linked to some coagulation disorder. (https://www.fip-ifp.org/wp-content/uploads/2020/04/acroischemia-ENG.pdf)
This might prove the concept that SARS-CoV 2 entered human by the lungs, through the ACE2 receptors; but did not always stopped at ARDS. Besides the Cytokine Storm Syndrome and multiple organ failures, it can also spread further thru ACE2 into the vascular endothelium, causing both central ( Kawasaki) as well as peripheral (Acroischemia) vasculitis and thromboembolism, which in turn account for some of the many organ damages.
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