Nineteen children have contracted a new serious childhood illness in recent weeks that is believed to be somehow related to Covid-19. Ten of the children tested positive for antibodies to SARS-CoV-2, the virus that causes Covid-19. This is evident from a survey conducted by the Dutch Association for Pediatrics (NVK).
The NVK asked Dutch pediatricians two weeks ago to report all cases of the new condition they encounter. The new disease appears to be a combination of two known diseases: the rare Kawasaki disease, which almost exclusively affects children under 5 years of age, and toxic shock syndrome (TSS).
“Only four of the nineteen patients were under five years old,” says NVK chairman Károly Illy, a pediatrician at the Rivierenland hospital in Tiel. “Ten out of nineteen patients have had antibodies against the coronavirus.”
So not at nine, but that does not mean that it is certain that they did not go through an infection. The tests are too unreliable to make any definite statements about this. It is not known how the children are doing now.
Kawasaki disease causes the blood vessels in the heart to swell. It is a treatable condition. Patients usually have swollen glands, dry and chapped lips and (severe) rashes. Kawasaki patients’ fingers and toes and their palms and soles are often strikingly red.
Toxic shock syndrome – also known as tampon disease because highly absorbent tampons can play a role – is caused by bacteria that secrete toxins in the body. TSS is accompanied by a high fever, severe rash, flu-like symptoms. Because it can lead to multi-organ failure – kidney failure, liver failure, but also a lack of oxygen due to malfunction of the lungs – toxic shock syndrome is a life-threatening condition.
The bacteria that cause TSS are Staphylococcus aureus and Group A streptococci. Many people carry S. aureus with them, especially in their nose or on their skin. This usually does not hurt, unless the bacteria gets into wounds or wounds. S. aureus and MRSA, the multidrug-resistant variant, are notorious for the postoperative wound infections they often cause in hospitals.
Group A streptococci also usually cause mild infections, but if they enter the bloodstream or underlying tissue, they can have serious consequences. Streptococci can cause maternity fever, a form of sepsis that affects women who have just given birth.
Immune system overreaction
Professor of Pediatric intensive care at the Amsterdam UMC Job van Woensel previously told Medical Contact that the unknown clinical picture in children is caused more by an overreaction of the immune system than by the virus itself. This overreaction is seen in many covid patients and is caused by what has come to be known as a “cytokine storm.”
Cytokines are proteins that regulate the immune response of the immune system. There are two types of cytokines: anti-inflammatory and anti-inflammatory. A subtle interplay of both ensures that the immune system overcomes an infection. However, excessive production of anti-inflammatory cytokines can cause a much more serious course of the infection.
Many covid-19 patients have seen that the immune system goes into overdrive, as it were, and leads to very serious complaints. This often happens after covid-19 initially appears to be somewhat under control. That cytokine storm, like the new serious childhood illness, can cause organ failure.
The first reports of the new childhood disease possibly related to covid-19 surfaced a month ago in the United Kingdom, where the child intensivists published a warning to be alert to the new disease. Ireland and Belgium, Switzerland, Italy, Spain, France and the US followed.
In New York alone, there are 102 patients, according to Governor Cuomo. Three children have died. Fourteen other U.S. states also report cases, according to The New York Times.
In France, the total number of cases last week had risen to 135. One patient has died. It has been established that he did not have covid-19, but blood tests would have shown that he was in contact with the virus.