Coronavirus (COVID-19) in children – new symptoms to look for and signs of Kawasaki disease

Children dying or becoming seriously ill from Covid-19 is thankfully very rare. However, there are emerging concerns about a severe new illness affecting children that could be related to coronavirus.

The condition, which has been called paediatric inflammatory multisystem syndrome (PIMS), has symptoms similar to sepsis, Kawasaki disease (a rare illness which mainly affects children under the age of five, with coronary artery aneurysms as its main complication), and toxic shock syndrome (including a high temperature, lethargy and inflammation).

The World Health Organisation say clusters of children with the condition have been identified throughout Europe and the USA. Last month eight-month-old Alexander Parsons, from Plymouth, died after being diagnosed with Kawasaki disease. His parents have now launched a crowdfunding campaign to raise awareness of the possible links between coronavirus and Kawasaki-like symptoms – which include a high temperature, rashes and swelling.

Coronavirus (COVID-19) in children – new symptoms to look for

However, medical experts say it’s currently unclear whether coronavirus is the trigger, or if there’s a new Kawasaki-like disease causing multisystem inflammation.

The Royal College of Paediatrics & Child Health  (RCPCH) stresses the illness has affected an “extremely small number of children” – around 20 in the UK and a smaller number across Europe. It says that of those who required intensive care, many have now made a good recovery, although some still need very intensive therapy.

A spokesperson for the RCPCH says: “This is an extremely rare condition. We don’t know the exact number of children who have had the syndrome but it’s a very, very small percentage considering how many children have had Covid-19. We don’t know if it is definitely linked to the virus but we think that’s likely to be the case.”

She says the RCPCH is conducting research to find out how many cases have been seen by doctors in the last few months, and the data should be available soon. Adding: “It will include all the cases that seemed to resemble the syndrome and will range from children who’ve been very unwell and treated in intensive care, to all the children who were not seriously affected with the condition and are well again, though doctors will continue to carefully monitor these children.”

Paediatrician Dr Mike Linney, an RCPCH registrar, says PIMS can have very varied symptoms and doctors look for a pattern of combined signs. He stresses: “There is no one sign or symptom which alone would indicate that a child has the condition.”

What are the new coronavirus (COVID-19) in children symptoms to spot?

The RCPCH says symptoms of PIMS may include:

1. Fever and inflammation: A persistent high temperature and inflammation. A child is likely to be extremely unwell.
2. Sepsis-like symptoms: Children may display features suggestive of sepsis, and as well as fever there may be rapid breathing, cold hands and feet and sleepiness.
3. Abdominal problems: There may sometimes be unusual abdominal symptoms.
4. Organ involvement: Doctors may identify evidence of single or multi-organ dysfunction (shock, cardiac, respiratory, renal, gastrointestinal or neurological disorder), with additional features which may include Kawasaki disease symptoms.
5. Not necessarily positive for coronavirus: Testing for Covid-19 may be positive or negative. In addition, other microbial causes will be ruled out, including bacterial sepsis, staphylococcal or streptococcal shock syndromes, or infections associated with myocarditis such as enterovirus.

Donate to Alexander Parsons’ Just Giving page here.

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