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Tuesday, May 5, 2020

What is Kawasaki disease and is it linked to the coronavirus? Last Study


Symptoms of a rare inflammatory condition are identified in a minimum of 15 children in ny City hospitals, alarming pediatricians across the country and raising concerns a few possible link to the coronavirus.

The patients exhibited symptoms typically seen in Kawasaki disease or toxic shock syndrome syndrome, including a persistent fever, consistent with the city’s health department.

The children were between 2 and 15 years old and were identified between April 29 and should 3. While all the patients had a fever, quite half them reported a rash, abdominal pain, vomiting or diarrhea.

In an alert issued to doctors, the NYC health department said but half the patients exhibited respiratory symptoms. Four of the cases tested positive for COVID-19, while 11 tested negative.

No deaths are reported, but many of the patients required vital sign support and five of them required mechanical ventilation, the city’s health department said.
Both Kawasaki disease and COVID-19 are illusive conditions that doctors are still studying. Some experts doubt there is a link between the 2 while others do not believe the mysterious symptoms belong to Kawasaki in the least .

What is Kawasaki disease?
“Kawasaki disease is one among the good mysteries in pediatrics,” said Dr. Frank Esper, a physician at the Cleveland Clinic’s Center for Pediatric Infectious Diseases. “It’s something we’ve been handling for many years .”

Symptoms include a fever of a minimum of 101 degrees that lasts for five days or more, a rash and swollen glands within the neck, consistent with Britain's National Health Service. Esper says that it predominately affects children between the ages of two and 6, tends to run during "mini-epidemics," and is more likely to happen within the winter than the summer.
While doctors skills to treat Kawasaki disease , they still don’t know what causes it or why some people catch on . Esper says "a cemetery of various reports" have hypothesized the disease is caused by viruses while others say people could also be genetically predisposed.

“Kawasaki disease is that the boogeyman to pediatricians,” he said. “It’s extremely difficult to diagnose. Even with the foremost astute clinicians, we've a tough time deciding who has it and who doesn’t.”
Esper says the most indicator of the disease are often found within the heart. arteria coronaria aneurysm, or a dilation of the coronary arteries, is what distinguishes Kawasaki from the other disease .

First cases with COVID-19 concern appeared in Europe
The condition was first reported by doctors in Britain, Italy and Spain in late April. Britain’s Paediatric medical care Society issued an alert noting there had been a rise within the number of youngsters with “a multi-system inflammatory state requiring intensive care” across the country.
The group said there was “growing concern” that either a COVID-19 related syndrome was emerging in children or that a special , unidentified disease could be responsible.

Spain’s Association of Pediatrics recently made an identical warning, telling doctors that in recent weeks, there had been variety of school-age children affected by “an unusual picture of abdominal pain, amid gastrointestinal symptoms” that would lead within hours to shock, low vital sign and heart problems.
Is Kawasaki disease associated with the coronavirus? 
Experts say it's too early to inform if the disease are often related to COVID-19. 

“We’ve never seen the coronavirus before but we’ve been handling Kawasaki disease for many years ,” Esper said.

He also said that experts aren't even sure if the mystery disease shooting up in parts of Europe and therefore the U.S. are often definitively identified as Kawasaki disease . So far, he hasn't seen any the reports mention arteria coronaria dilation, which might be a serious indication. 

"I will caution that there are many things that look almost like Kawasaki disease ," Esper said. "It might be that what they’re calling Kawasaki isn't Kawasaki but an disease caused by the coronavirus." 

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Dr. Sunil Sood, a pediatric communicable disease physician at Northwell Health's Southside Hospital and Cohen Children's center , doesn't believe the condition is Kawasaki. 

Sood says patients he's treated are sicker, with inflammatory markers 10 to 100 times above average child with Kawasaki disease . 

Although the ny City Health Department only mentioned 15 cases in their alert, Sood says he's had a minimum of 20 cases between the 2 hospitals where he's employed . Only three of his cases tested positive for coronavirus with the regular PCR test, but the remainder tested positive for coronavirus antibodies. 

He estimates his patients may have had the virus, even unknowingly, four weeks before developing the inflammatory condition. 

"The system can overreact during a delayed timeline many weeks later," Sood said. "We know this from other infectious diseases."


He advises parents and pediatricians to seem out for a fever also as a mixture of any of those symptoms: Abdominal pain, confusion, diarrhea, red eyes, rash, swollen hands and feet, difficulty breathing and spending out. Sometimes the abdominal pain are often so severe that it mimics appendicitis. 

Sood urges parents to bring their children to the hospital if they develop any symptoms because it could lead on to further heart complications, even acute coronary failure .

"Initially, i assumed it had been Kawasaki ... but it's going beyond those symptoms," he said. "Pediatricians and fogeys should remember that there’s an epidemic of this immediately ."

While there is a spike in these cases, Sood says that children are still among the smallest amount affected group by the coronavirus. Data from quite 75,000 cases in China showed they comprised 2.4% of all confirmed cases and mostly suffered only mild symptoms.