Coronavirus

Children with symptoms similar to Kawasaki: four cases in Germany

Actually, children with Covid-19 often show no or only mild symptoms.

Stefan Cristian Cioata / Getty Images

The girl was only six months old, had a fever, swelling in her arms and legs, rashes, conjunctivitis, and chapped lips. The doctors know this picture. It is rare, but almost only occurs in children: typical symptoms of the so-called Kawasaki syndrome. With this disease, the blood vessels in the body are inflamed, so the symptoms are widely spread and mostly affect the entire body. The girl’s doctors, however, were taken aback and decided to write down her case and publish it for colleagues – because the baby was also infected with the new Sars-CoV-2 coronavirus.

That was in early April. The girl was quickly recovering, but since then there have been reports of children infected with Sars-CoV-2 and symptoms similar to those of Kawasaki syndrome from several countries around the world. London doctors had reported frequent cases, as did doctors from Bergamo, Italy, and doctors from the United States. By mid-May, 230 cases were counted – five children died as a result of the disease.

Now the first cases have apparently occurred in Germany, as the “Tagesspiegel” reports. In the children’s hospital “Auf der Bult” in Hanover, four children between the ages of three months and 13 years were treated with symptoms similar to the Kawasaki syndrome. All four had a long-lasting fever, but then developed different symptoms: from conjunctivitis and skin rash to pneumonia and gastrointestinal inflammation. But in all of them the doctors found antibodies against Sars-CoV-2.

The new cases are more severe than doctors know from Kawasaki syndrome

All children had an uncomplicated course and were treated in the hospital for between four and twelve days, according to the “Tagesspiegel” – by now everyone is back home. Apparently there are also first cases in Munich and Dresden, as the hospital press office said.

In the meantime, the European Center for Disease Prevention and Control (ECDC) has christened the disease “Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection, PIMS for short. The reason: The cases that now occur are more often more severe than doctors know from Kawasaki syndrome.

How exactly the two clinical pictures can be differentiated, and whether Covid-19 is directly related to PIMS is still unclear. It is a rare disease, “the potential connection to Covid-19 is neither proven nor well understood,” said the ECDC.

The cause of the symptoms and the link to Covid-19 is unknown

Doctors are therefore still divided on the cause of PIMS. However, some believe that the disease is triggered by an overreaction of the immune system.

The cases raise new questions about the coronavirus and how dangerous it is to children – after all, it has long been assumed that Covid-19 is uncomplicated for most children and even completely symptom-free for many.

The president of the professional association of pediatricians Thomas Fischbach had previously warned in the “Neue Osnabrücker Zeitung” of panic and asserted that there was no evidence of a connection between Covid-19 and Kawasaki syndrome.

Philipp Hennecke from the Clinic for General Pediatric and Adolescent Medicine at the University Hospital had expressed similar skepticism in “Munich Mercury”. There are around 200 Kawasaki cases in Germany each year. The newspaper cited the doctor that the cases were not demonstrably “corona-induced”.

And the Berlin virologist Christian Drosten had recently said in the NDR podcast that there was no reason for alarmism. The syndrome is still a rare phenomenon that is now being discussed in specialist circles. In addition, according to Drosten, the symptoms are well treatable based on previous knowledge.

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