Boy dies of Kawasaki-like disease linked to coronavirus
Teenager had no co-morbidities but tested positive for COVID-19
A 14-year-old boy with no underlying health conditions has died from a Kawasaki-like disease linked to COVID-19.
The boy had spent six days in intensive care at the Evelina and a post-mortem test for COVID-19 was positive.
His main symptoms on admission were a temperature above 40˚C, diarrhoea, abdominal pain and headache.
Cluster of cases of children with Kawasaki-like symptoms
The teenager was part of a cluster of eight young people with Kawasaki-like symptoms who were studied while being treated at the Evelina London Children's Hospital over a ten-day period in April.
His death follows a recent NHS England alert to GPs about a rise in the number of children presenting with features of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe COVID-19.
The seven other children in the study survive with one having been diagnosed with COVID-19. All tested positive for antibodies and have had exposure to people with COVID-19.
Presentations at the Evelina have risen
Since the end of the study the Evelina has seen the number of children with Kawasaki-like symptoms rise to 20, according to a report from the Evelina medical team published in The Lancet.
The report states: ‘All children were previously fit and well. Six were of African-Caribbean descent, and five were boys.’
They had similar symptoms, including unrelenting fever, variable rash, conjunctivitis, swelling, pain and significant gastrointestinal symptoms.
Most of them had no significant respiratory symptoms during hospital stays, although seven were ventilated to stabilise their cardiovascular systems.
Multiple specialties were involved in children's treatment and care
The team said multiple specialists were needed for any children presenting with the syndrome, including from intensive care, cardiology, infectious diseases, immunology and rheumatology.
The health and social care secretary Matt Hancock said last month experts are investigating Kawasaki syndrome in relation to COVID-19 ‘with great urgency’.
The Paediatric Intensive Care Society last month urged nurses to inform paediatric critical care teams if a child presents with an unusual clinical picture consistent with COVID-19 symptoms.
Professor urges caution about COVID-19 link
However, an expert in infectious diseases is urging caution about linking COVID-19 to an emerging toxic shock-style inflammatory syndrome in children.
Brighton and Sussex Medical School emeritus professor of infectious diseases, Jon Cohen, said the syndrome ‘can be precipitated by various stimuli and it is conceivable this cluster was caused not by COVID but some other infective or non-infective stimulus’.
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