Kawasaki-like syndrome more likely to affect black children, study suggests

Study at Paris hospital highlights need for vigilance on rare syndrome linked to coronavirus

Picture shows a young black boy lying in a hospital bed, clutching a toy
Picture: iStock

A rare syndrome in children and adolescents thought to be linked to COVID-19 is more likely to affect those of African heritage than those who are white, a small study suggests.

The observational study of 21 children admitted to a teaching hospital in Paris, the Necker-Enfants Malades hospital, with features of the syndrome found that 12 (57%) were of African or Caribbean heritage. Six (29%) were white and 3 (14%) were Asian.

The authors said: ‘In this study an unusually high proportion of the affected children and adolescents had gastrointestinal symptoms, Kawasaki disease shock syndrome, and were of African ancestry.’

Main symptoms of the condition are a high and persistent fever and a rash

Royal College of Paediatrics and Child Health president Russell Viner said in mid-May that 75-100 children in the UK had been affected by the condition.

A boy aged 14 with no underlying health problems treated at the Evelina London Children’s Hospital, part of Guy’s and St Thomas’ NHS Foundation Trust, was the first child to die from the syndrome in the UK.

Professor Viner stressed at the time that the condition was rare and appeared to occur mostly after coronavirus infection.

The main symptoms of the condition are a high and persistent fever and a rash, while some children also experience abdominal pain and gastrointestinal problems. Although some patients have required intensive care, others have responded to treatment and been discharged.

The illness has been compared to Kawasaki disease, which mainly affects children under the age of five, with symptoms including a high temperature, rashes, swelling and a toxic shock-like response.

The new study in Paris, published in the British Medical Journal, found that all 21 children affected had gastrointestinal symptoms – abdominal pain, often with vomiting and diarrhoea – while rash and myocarditis were other common symptoms, affecting 16.

Social and living conditions, and genetic susceptibility, need to be explored

The children, aged 3-16, were admitted to hospital between 27 April and 11 May and 19 had evidence of recent COVID-19 infection. Although 17 of the patients needed intensive care, all had been discharged home by 15 May with no serious complications.

The researchers said their findings ‘should prompt high vigilance’ among health professionals, particularly in countries with a high proportion of children of African background.

They said more research was needed but factors such as social and living conditions, and genetic susceptibility to the illness, needed to be explored.

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Kawasaki-like multisystem inflammatory syndrome in children during the COVID-19 pandemic (BMJ)

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