Lahore: cases of disease, such as Kawasaki disease (KD), which is considered post-infectious complications among children infected with Covid-19 began surfacing in different parts of the country, causing alarm among experts.
The Institute of child health children’s hospital/Lahore received three such cases, while some others were registered in Karachi, Islamabad and Rawalpindi. These cases have alarmed the “unprepared” kids experts across the country.
Also known as Kawasaki syndrome, KD is an acute febrile disease of unknown etiology that primarily affects children under the age of five years. The disease was first discovered in Japan, Tomisaku Kawasaki in 1967. The first cases outside of Japan were recorded in Hawaii in 1976.
However, clinical signs of KD include fever, rash, swelling of hands and feet, irritation and redness of the white part of the eyes, swollen lymph nodes in the neck, and irritation and inflammation of the mouth, lips and throat.
“It is very disturbing to us that three children were hospitalized in children’s hospital Lahore with a CD-like syndrome and other similar cases are also reported from Rawalpindi/Islamabad and Karachi”, the hospital Dean prof Dr Masood Sadiq told dawn on Tuesday.
ICH Lahore is the largest facility in the public sector in Pakistan for the treatment of minors suffering from rare and complex diseases.
He said that the outbreak of Kawasaki-like disease may occur in countries such as Pakistan, which were affected by SARS-cov-2 pandemic, commonly called the coronavirus responsible forCOVID 2-19.
He said that pediatricians were alerted across the country to address this new emergency to protect children.
“In Pediatrics and cardiologists should be aware of this new disease, which resembles BK, but has a sharp severe and most likely associated with SARS-cov-2 infection,” Professor Sadiq said.
He said that early diagnosis, appropriate referral and management can lead to a favorable outcome, using accepted methods of treatment.
His statement was made after the first death of a child in Punjab (children hospital Lahore) caused by Covid-19.
He said Covid-19 caused by a coronavirus 2 was also observed in children, however, were relatively fewer of these cases compared with the prevalence of the disease among adults.
“Children [as per international medical criterion] below 19 years old make up 7.28 percent (12,858 of 176,617) of the total reported confirmed cases Covid-19 in Pakistan, with a mortality rate of 0.46 PC (16 of 3,501 to 15 years),” he said, citing Federal government statistics.
He said that this ratio is one of the highest rates in the world during a pandemic coronavirus.
“In USA, 2pcs confirmed cases Covid-19 cases were registered among persons under the age of 18 years, with a further 2.2 PC in China,and 1.2 PC in Italy and 0.8 PC, Spain,” Prof Dr Masood Sadiq said.
Fortunately, he said, the impact Covid-19 in children, generally mild.
Most are either asymptomatic, or experience only minor symptoms. Quoting data, he said, 4pcs of cases are asymptomatic (without clinical signs or symptoms, with normal chest imaging), 51pc weremild cases, with symptoms including fever, fatigue, myalgia, cough, 39pc moderate pneumonia with symptoms or subclinical disease with abnormal chest imaging. The figures showed five severe cases of PK (shortness of breath, Central cyanosis, hypoxia), and only 0.6 PC critical cases with acute respiratory distress syndrome [ARDS], respiratory failure, shock or multiple organ dysfunction.
He said that although children with Covid-19, usually do not get the serious form of the disease, they become carriers and can infect their grandparents and other people houses.
However, he said, children with comorbidities such as chronic renal failure, congenital heart disease (CHD), chronic liver disease, those on steroids, lung disease, as tuberculosis or suffering from asthma, etc. may become seriously ill and even die.
“Such centers in Europe and the United States recently reported a multi-systemic inflammatory syndrome, on children associated with Covid-19. In children (MO-S) and young people (under 19 years of age), temporarily associated with SARS-coronavirus-2 of the pandemic, increased serological markers of inflammation and levels of cytokines, which is a major cardiovascular compromise is a key element,” he said.
Prof Sadiq, who is also one of the leading pediatric cardiologists of Pakistan, said the affected children were shown a systemic failure with significant inflammation which resembled Kawasaki disease.
“These patients manifest features of atypical Kawasaki disease with inflammation of the heart overlap syndrome toxic shock syndrome and Kawasaki disease shock,” he said.
“This is most likely after infection complication of SARS-cov-2 and its fall 1out of 1000 children affected by Covid-19”, – he said.
This was the condition when different parts of the body could be inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal tract, he said.
Many children with MIS-s-a virus that was Covid 19, or has been around someone with Covid-19.
“MIS-s can be serious, even fatal, but most children who have been diagnosed with this condition has become better with medical help,” he said.
Typical symptoms of fever (below 38.0°C for 3 days, or to report subjective fever lasts more than 3 days), multi (more than 2 days) body of the lesion (heart, kidney, respiratory, hematological, gastrointestinal, dermatological and neurological) and positive for current or recent SARS-cov-infection 2-PCR, serology, or antigen test; orCovid-19 aging for 4 weeks before the onset of symptoms.
Prof Sadik came to the conclusion that the majority of affected children may require mechanical ventilation for cardiovascular stabilization.
Published in dawn on 1st July 2020
to request modification Contact us at Here or [email protected]