Severe hyperinflammation can affect children after covid-19

Recently, a number of cases were reported in which children in both the UK and Italy suffered from a serious inflammatory disease. Since several of the children had been tested positive for covid-19, suspicions soon arose that it was the corona virus.

Shortly thereafter, 15 cases were also discovered in New York, USA, three of which later died. Even in the UK, children have died.

Now Italian researchers in the journal The Lancet describe ten cases discovered in the province of Bergamo in northern Italy, one of the areas worst affected by the virus. It is 30 times more than what usually gets sick in a serious inflammatory disease called Kawasaki's disease.

The article authors call the disease Kawasaki-like disease. It is a very rare inflammatory disease affecting the blood vessels of children under five years. 

But Jonas F Ludvigsson, a pediatrician in Örebro and professor of chronic epidemiology at the Karolinska Institute, wants to call this difficult condition something else.

 - I would like to call it "covid-19 associated hyperinflammation" and it is a life-threatening condition. Most children we have seen in the UK and in Italy have been between five and fifteen years, he says.

Almost all affected children have had a covid-19 infection, but have not had any typical covid-19 symptoms.

- These kids have probably reacted to covid-19 and their immune systems have overreacted. Those children who become ill in conjunction with covid-19 themselves often have difficulty breathing. Now we see severe heart effects instead, says Jonas F Ludvigsson.

The children get high fever, inflammation of the heart and whole body and organ failure. Organ failure may prove that the heart is unable to pump blood, kidneys and liver are unable to perform their tasks in the body and a high proportion of children with covid-19-associated hyperinflammation have needed respiratory care.

The children were in most cases treated with both immunoglobulin and cortisone.

- We have had at least one likely fall in Sweden. But even though there are reports of children with hyper-inflammation now, one must remember that the condition is extremely unusual, he says, says Jonas F Ludvigsson.

This hyper-inflammation affects children who have previously been completely healthy, children with chronic illnesses and congenital heart defects are not at risk.