NHS warns of rise in children with new illness that may be linked to coronavirus

By Denis Campbell Health policy editor

Children are falling ill with a new and potentially fatal combination of symptoms apparently linked to Covid-19, including a sore stomach and heart problems.

The children affected appear to have been struck by a form of toxic shock syndrome. Some have been left so seriously unwell that they have had to be treated in intensive care. At least one has undergone extra corporeal membrane oxygenation (ECMO) treatment, which is used when someone’s life is at risk because they can no longer breathe for themselves.

It is not known how many such cases have appeared, though it is thought to be a small number. But NHS bosses are so concerned that they have written to doctors alerting them to the existence of the syndrome and asked them to urgently refer any children who appear to have it to hospital.

In a letter to GPs in north London, reported by the Health Service Journal , NHS bosses said: “It has been reported that over the last three weeks there has been an apparent rise in the number of children of all ages presenting with a multi-system inflammatory state requiring intensive care across London and also in other regions of the UK.

“The cases have in common overlapping feature of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe Covid-19 in children.

“There is a growing concern that a Sars-CoV-2-related inflammatory syndrome is emerging in children in the UK, or that there may be another, as yet unidentified, infectious pathogen associated with these cases.”

A version of the warning has been sent by the Paediatric Intensive Care Society to all specialist doctors working in paediatric intensive care units in UK hospitals.

The NHS letter continues: “Abdominal pain and gastrointestinal symptoms have been a common feature, as has cardiac inflammation. This has been observed in children with confirmed PCR positive Sars-CoV-2 infection as well as children who are PCR negative. Serological evidence of possible preceding Sars-CoV-2 infection have also been observed.”

Sars-CoV-2 is the official name of the virus that causes the disease Covid-19.

Doctors have been told to “please refer children presenting with these symptoms as a matter of urgency”.

One intensive care doctor told the Guardian: “There’s been an utterly unexpected uptick in severely sick children with a late inflammatory response that we think is related to Covid-19. It’s most unusual. A number have needed ICU [intensive care] and at least one has required ECMO.”

It is not known if any children struck by the new syndrome have died.

Prof Russell Viner, the president of the Royal College of Paediatrics and Child Health, sought to reassure parents that children are generally unlikely to become very unwell due to Covid-19.

“We already know that a very small number of children can become severely ill with Covid-19 but this is very rare. Evidence from throughout the world shows us that children appear to be the part of the population least affected by this infection.

“New diseases may present in ways that surprise us, and clinicians need to be made aware of any emerging evidence of particular symptoms or of underlying conditions which could make a patient more vulnerable to the virus. However, our advice remains the same: parents should be reassured that children are unlikely to be seriously ill with Covid-19, but if they are concerned about their children’s health for any reason they should seek help from a health professional.”

The RCPCH’s guidance for parents on symptoms and seeking advice is available here.