Pamela Cruz. Peninsula 360 Press [P360P].
Since a cluster of pneumonia cases due to unknown causes was first reported in Wuhan, Province of China, in December 2019, the pandemic caused by COVID-19 has spread rapidly around the world, according to a study published in a British journal.
Globally, according to data from Johns Hopkins University, there are around 79 million 712 thousand confirmed cases of COVID-19 and one million 747 thousand 790 deaths; while in the U.S. there are 18 million 733 thousand cases and 330 thousand deaths.
And although there is a belief among the population that children are not affected by this disease, statistics from countries in Asia, Europe and North America show that pediatric cases may account for up to 7.8 percent of confirmed cases of COVID-19.
According to the study "COVID-19 and Multisystemic Inflammatory Syndrome in Children and Adolescents", published in The Lancet, although the manifestations of the disease are generally milder in children, a small proportion require hospitalization and intensive care.
And according to the report, from September to November 2020 there has been an increase in reports from Europe, North America, Asia and Latin America describing children and adolescents with COVID-19-associated multisystem inflammatory conditions (MIS-C), which appear to develop after the peak of the disease.
It should be noted that the clinical features of these pediatric cases are similar to other syndromes and conditions, such as Kawasaki disease, Kawasaki disease shock, and toxic shock syndrome, although they have distinctions.
The research mentions that in the current COVID-19 pandemic there was an increase in observations of an inflammatory disease occurring in children; of which, most of the reports were weeks after the peak of COVID-19 infections in those affected.
On April 7, 2020, a case of a six-month-old infant was first reported in the U.S., presenting with persistent fever and minor respiratory problems, who was diagnosed with Kawasaki disease and tested positive for SARS-CoV-2.
On April 24, 2020, the UK National Health Service issued an alert about an emerging pediatric multisystem inflammatory disorder. Since then, several other countries have reported multisystem inflammatory disease temporally associated with SARS-CoV-2 infection.
In this regard, he refers that MIS-C cases started to appear about one month after a peak of COVID-19 in the population. And it is that the number of cases in the UK increased dramatically around April 16, 2020, four weeks after the substantial increase in UK cases. Epidemiological studies from the US and France revealed similar trends.
Also, only one-third of the reported MIS-C cases were positive by RT-PCR for SARS-CoV-2, while the majority of cases were positive with an antibody test, indicating past infection in the child.
Thus, the delay in the presentation of this condition relative to the pandemic curve, a low proportion of cases testing positive for COVID-19, and a high proportion of positive antibodies suggests that this inflammatory syndrome is not mediated by direct viral invasion, but coincides with the development of acquired immune responses to SARS-CoV-2.
The study indicates that there are no widely accepted guidelines on the management of MIS-C, but several organizations have published their own guidelines. Physicians at several centers have even created treatment protocols based on specific or similar symptoms, such as Kawasaki disease.
Finally, the report explains that with the small number of cases reported worldwide, it is vital to establish international research collaboration to conduct these relevant studies in a coordinated and effective manner.
It also states that more studies are needed to determine the effectiveness and safety of these treatments and to determine the long-term results and sequelae.
In addition, it is essential to incorporate this differential diagnosis in pediatric patients affected with SARS-CoV-2 in order to avoid delaying diagnosis and to establish timely treatment at an early stage.
