Virus may be triggering inflammatory response in children
Some experts think kids may be experiencing overreaction from their immune system, causing Kawasaki disease
A potentially fatal inflammatory syndrome that has afflicted about 100 children worldwide could have arisen from an overreaction from their immune system in response to the coronavirus, experts have said.
In recent weeks, doctors in Britain, the US, France, Italy, Spain and Switzerland reported a trend of critically ill children with low blood pressure and inflamed organs - severe symptoms of a condition called Kawasaki disease (KD).
Many tested positive for the coronavirus, while some had to be admitted to intensive care.
The World Health Organisation is "urgently" investigating a possible link between the virus and KD, which involves inflammation of blood vessels.
There have been 57 children aged 16 and below who have been infected here as of last Sunday. Among them, 42 have been discharged and none have been in intensive care.
In an e-mail interview with The New Paper, paediatric infectious disease expert Nipunie Rajapakse from the Mayo Clinic in the US said children with KD will have a fever that persists for at least five days. They may also develop rashes, swollen hands and feet, enlarged lymph nodes, inflamed lips and tongue, or conjunctivitis without eye drainage, she said.
In rare cases, they may show symptoms of shock - low blood pressure with poor blood flow to their organs - or decreased heart function.
Paediatrician Ooi Pei Ling said only about 5 per cent of KD patients will exhibit these severe symptoms, which could be life-threatening.
She said paediatricians in Asia regularly treat children with KD, typically aged five and below.
According to her estimates, about 80 to 90 children in Singapore suffer from it every year.
USED TO IT
"We are quite used to seeing KD here. Why the West is alarmed is likely because they usually see fewer cases, and that is believed to be due to genetic factors," she told TNP.
"The difference for us now is that for our typical volume of KD cases, we may see more with severe symptoms, more than the usual 5 per cent."
Dr Rajapakse said more research has to be done to understand how or whether the recent cases are linked to the coronavirus, but the high incidence during the pandemic suggests the two are likely related.
Experts suspect the virus may have triggered the inflammatory syndrome by activating the immune system of children and sending them into overdrive to fight the infection.
The response may even be post-infectious, meaning the virus may not be detected in the child by the time the symptoms kick in, Dr Rajapakse said.
Parents should not be overly concerned, as reports of this syndrome are very rare, she said.
Dr Yung Chee Fu, an infectious disease consultant in the department of paediatrics at KK Women's and Children's Hospital (KKH), told TNP on Monday that children at KKH with the coronavirus have not presented such complications.
"However, Sars-CoV-2 is a novel virus and there are still many unknowns. We will continue to monitor all our patients closely and provide appropriate clinical care," he added.