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The kids aren’t alright: COVID-19 and shock syndrome seen in children



By Jasmine Belfiore.


There have been rumours that COVID-19 is milder in children and adolescents or even that it doesn’t occur in children at all. That narrative is changing. Not only do infants seem to experience more severe illness than older children, but even children with milder symptoms need to be hospitalised. On top of this, a severe inflammatory syndrome that affects multiple organs is now thought to be caused by COVID-19 and affects children at a higher rate than adults. This theory that children are safe from COVID -19 becomes more and more unlikely every day.


A study conducted in Paris explicitly draws a connection between shock syndrome and Covid-19.


Background


Multisystem inflammatory syndrome seen in children and adolescents in Paris may be linked to COVID-19.


Aim


To describe the features of a multisystem inflammatory syndrome that may be related to COVID-19 infections in children and adolescents.


Study design


Observational study in which 21 people aged 18 and under admitted to hospital between 27th April and 11th May 2020. The study looked at clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes.


Results


All people had gastrointestinal symptoms and high amounts of inflammation. 90% were found to be positive for COVID-19. 57% presented with a shock syndrome. 76% had myocarditis. 81% needed support from an intensive care unit.


Conclusions


There is likely a causal link between the COVID-19 outbreak in Paris, France and the rising cases of inflammatory syndrome seen in children and adolescents.


Limitations


  • Potential recruitment bias

  • Small sample size

  • Household members not tested for ongoing infection

  • Small chance of false positive COVID-19 tests


Glossary


Echocardiographic tests - using sound waves to create moving pictures of your heart


Gastrointestinal symptoms - stomach problems such as heartburn, indigestion/dyspepsia, bloating and constipation


Myocarditis - inflammation of the heart


Multisystem - involving more than one organ


References


Sankar, Jhuma et al. “COVID-19 in Children: Clinical Approach and Management.” Indian journal of pediatrics vol. 87,6 (2020): 433-442. doi:10.1007/s12098-020-03292-1


Toubiana, J., Poirault, C., Corsia, A., Bajolle, F., Fourgeaud, J., Angoulvant, F., Debray, A., Basmaci, R., Salvador, E., Biscardi, S. and Frange, P., 2020. "Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study". British Medical Journal, 369. doi:https://doi.org/10.1136/bmj.m2094 (Published 03 June 2020)



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