Dozens of children in the UK, US and elsewhere in Europe have been affected by a rare inflammatory disease linked to coronavirus – including a 14-year-old boy who died in London in April.
The teenager was part of a cluster of eight cases treated at the Evelina London Children’s Hospital over a 10-day period last month.
In Bergamo, the hardest hit city in Italy, there has been a “30-fold increased incidence” of Kawasaki-like disease in children at the Papa Giovanni XXIII Hospital in the past month, a study in The Lancet journal found.
The Italian researchers concluded that COVID-19 “might cause a severe form of Kawasaki-like disease”.
As of last week, the London hospital has seen more than 20 children with the Kawasaki-like disease, according to a report from the medical team in The Lancet.
The 14-year-old spent six days in intensive care at the Evelina and tested positive for COVID-19 following his death, his medical team reported.
His main symptoms on being admitted to the hospital were a temperature over 40C, diarrhoea, abdominal pain and headache.
The youngest child in the cluster treated at the Evelina was aged four and two others were six.
Two of the children in the cluster, including the boy who died, were obese.
The report said: “All children were previously fit and well. Six of the children were of Afro-Caribbean descent, and five of the children were boys.”
Medics said all the children had similar symptoms when they were admitted, including “unrelenting fever”, “variable rash”, conjunctivitis, swelling, pain and “significant gastrointestinal symptoms”.
Most of the children had no significant respiratory symptoms during their time in hospital, although seven were put on a ventilator to stabilise their cardiovascular systems.
All of the children survived apart from the 14-year-old.
Health Secretary Matt Hancock said last month that experts are investigating the new syndrome in children “with great urgency” but has stressed it is rare.
In Bergamo, the other study found 10 children – seven boys and three girls – with an average age of seven-and-a-half had been diagnosed between 18 February and 20 April.
The study found children diagnosed after the COVID-19 pandemic began were older – previously they were about three-years-old – had a higher rate of cardiac involvement and features of macrophage activation syndrome (MAS), a systemic inflammatory response which can reach every organ in the body.
Last week, New York governor Andrew Cuomo confirmed three children have died from the illness, with health officials reviewing a further 73 cases.
The condition is said to be similar to Kawasaki disease, which mainly affects children under the age of five, with symptoms including a high temperature, rashes, swelling and a toxic shock style response.
The medics reseraching the London cases wrote: “We suggest that this clinical picture represents a new phenomenon affecting previously asymptomatic children with COVID-19 infection manifesting as a hyperinflammatory syndrome with multi-organ involvement similar to Kawasaki disease shock syndrome.”
The team said multiple specialists were needed for any children presenting with the syndrome, including from intensive care, cardiology, infectious diseases, immunology and rheumatology.