As of today, almost five million people have tested positive for COVID-19, and the number of fatalities caused by this nasty bug are already in an excess of 300,000 . The number of critical cases has been highest in older people and in immunocompromised persons such as diabetics, people with cardiac disorders, chronic lungs diseases or cancer patients etc.

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But surprisingly until now this virus has spared newborns and children to much extent. As global data suggests, clinical manifestations of COVID-19 are generally milder in children compared with adults, but there is also proof that some children do require hospitalization and intensive care. Very few cases of infants confirmed to have COVID-19 have been reported; those who are infected have been mostly born to mothers infected with the virus. But good news is that those infants have shown mild to no symptoms.

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Recently, however, worrying reports from North America and few European countries have described some children and adolescents requiring admission to intensive care units with a rare "multi-system inflammatory syndrome" with some features quite similar to those of a vascular disease called Kawasaki disease and a bacterial infection named toxic shock syndrome.

It is suspected that these cases might be related to COVID pandemic based on initial laboratory testing showing positive serology in a majority of patients but not all patients have tested positive for COVID. These children presented with high fevers and elevated levels of inflammatory markers such as CRF, signs that are common in shock and an acute pediatric heart condition called Kawasaki disease.

Kawasaki disease causes inflammation in arteries, particularly those that supply the heart with blood. If not treated quickly, it can lead to blocked blood flow and heart damage. It is mostly seen in children under 5, but can affect teenagers as well. The etiology of KD is unknown but it’s thought that it occurs when an infection causes the body’s own immune system to overreact. In people with serious Coronavirus infections, it's believed that much of the widespread organ damage is similarly caused not directly by the virus, but by the hyperactive immune reaction of the body against this deadly virus.

These teens also showed symptoms such as rash, abdominal pain, vomiting, and diarrhea. Case reports have described a presentation of acute illness accompanied by a hyperinflammatory syndrome, leading to multiorgan failure and shock.

—Reuters file photo

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These children ranging between 2-17 years have been treated with anti-inflammatory treatment, including parenteral immunoglobulin and steroids. Feedback from doctors suggest that anti-inflammatory regimen has shown significant promise to placate the symptoms.

It must be noted that the full spectrum of disease is still not known, and whether the geographical distribution in Europe and North America reflects a true pattern, or if the condition has simply not been recognized elsewhere. Also, is there any link between novel Coronavirus and Kawasaki disease at all? Or is this viral infection just be a trigger for some children to develop KD? We can't say anything with certainty at the moment.

But one thing is for sure that this is not something to ignore. As paediatricians, cardiologists and epidemiologists all over the world are pondering on the link between COVID and this rare inflammatory syndrome. WHO has notified the world already regarding the matter as the organization's coronavirus expert - Maria Van Kerkhove - said this in a presser:

“What we’ve asked for is for the global network of clinicians to be on alert for this and to ensure that they capture information on children systematically so that we can better understand what is occurring in children and so that we can better improve our understanding and guide treatment.”