BREAKING! Pediatrics: Study Indicates That Multisystem Inflammatory Syndrome More Predominant Among Children Of African Ancestry Infected With COVID-19
: French researchers have found that an inflammatory syndrome in children and adolescents, believed to be linked to COVID-19, seems to be more common among children of African ancestry.
The pediatric syndrome has been compared with Kawasaki disease, a rare condition which mainly affects children under five. Experts have said that it may be an "antibody mediated or delayed response" to COVID-19 that happens several weeks after infection.
The result findings based on a study from a hospital in Paris is published in The British Medical J
ournal or BMJ. https://www.bmj.com/content/369/bmj.m2094
Similar cases have also been reported in Italy, the UK and the US.
It was observed in the research that patients had characteristics that differ from those with classic Kawasaki disease. For example, an unusually high proportion had gastrointestinal symptoms (abdominal pain, often with vomiting and diarrhea), unstable blood pressure, and inflammation of the heart muscle (myocarditis).
The study team say further studies are needed, but these findings "should prompt high vigilance" among doctors, particularly in countries with a high proportion of children of African ancestry.
The researchers describe 21 children and adolescents (average age 7.9 years) with features of Kawasaki disease who were admitted to a hospital in Paris between 27 April and 11 May 2020. Over half of the children (12; 57%) were of African ancestry.
Among them,twelve children presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. Nineteen (90%) had evidence of recent COVID-19 infection.
It was observed that all 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers in their bloodstream.
Although 17 patients (81%) needed intensive care support, all patients were discharged home by 15 May 2020, after an average of 8 days in hospital, with no serious complications.
The study team point to some limitations, such as the small number of patients, and stress that this is an observational study, so can't establish a causal link with COVID-19 infection.
However they say this Kawasaki-like multisystem inflammatory syndrome seems to be more common in children of African ancestry, suggesting an effect of either social or living conditions or genetic susceptibility, and shows different clinical symptoms to classic Kawasaki disease.
The researchers conclude, "These clinical findings should prompt high vigilance among primary care and emergency doctors, and preparedness during the coronavirus disease 2019 pandemic in countries with a high proportion of children of African ancestry and high levels of community transmission."
The study team has added an important layer to the growing knowledge of this disorder, strengthening the connection between COVID-19 infection and this condition, says Dr Mary Beth Son at Boston Children's Hospital, in a linked editorial.
She stresses that this condition is so far rare but potentially severe, and warrants surveillance as well as collaborative research.
She warns that it seems highly likely that more reports will appear from around the globe but says the rapid release of publications such as this, "is the first step in this critical process."
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