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Monday 27 April 2020

NHS issues urgent alert amid spike in the number of children being admitted to intensive care with a new coronavirus-related 'inflammatory syndrome'

NHS issues doctors urgent alert about a coronavirus-related condition in children
NHS doctors have been issued an urgent alert about a sharp rise in the number of children being admitted to intensive care with a coronavirus-related condition. In an alert sent to GPs, health chiefs said: 'There is growing concern that a [COVID-19] related inflammatory syndrome is emerging in children in the UK. '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 features of toxic shock syndrome and atypical Kawasaki disease (pictured above) with blood parameters consistent with severe COVID-19 in children.' The alert was sent out by a clinical commissioning group in North London and tweeted by the Paediatric Intensive Care Society charity. The alert, seen by the Health Service Journal, told GPs to refer children with symptoms including abdominal pain as a 'matter of urgency'.



The memo, which was sent out by an NHS CCG in London - thought to be the North Central London CCG - and tweeted by the Paediatric Intensive Care Society, said: 'The cases have in common overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe COVID-19 in children.'  

The alert told GPs to refer children with symptoms including abdominal pain as a 'matter of urgency'.

The NHS still only lists a temperature and a new cough as the main symptoms of COVID-19, despite the World Health Organization saying it can cause diarrhoea and aches and pains and US officials saying it can cause patients to lose their sense of taste and smell. 

If the condition turns out to be common, it could add a new element of danger to the coronavirus outbreak, which so far appears to be sparing children.

Only nine people under the age of 19 have died in England in hospital after testing positive for COVID-19, out of a total of 18,420 reported by yesterday, April 26 - 0.05 per cent.

The deaths include 13-year-old Ismail Mohamed Abdulwahab from Brixton, who passed away at King's College Hospital in London at the end of March.

The reasons for this are unclear but scientists have suggested that lower rates of other serious illnesses and a lack of age-related lung damage may be protective. 

According to the NHS memo, cases of this inflammatory syndrome have only started to appear in the past three weeks - this may be because it is slow to develop or so rare that it has only become noticeable in the peak of the UK's epidemic.

A paediatrician at St Mary's Hospital in the capital, Dr Elizabeth Whittaker, said on Twitter that medics in other countries had reported the same illness.

Dr Whittaker said: 'Our Italian and Spanish colleagues also report it. 

'Numbers are small but significant. We want primary care/A&E to be vigilant so those affected are in the right place to get appropriate supportive care if needed.'   

But Dr Michael Griksaitis, a paediatric at the University Hospitals Southampton NHS Foundation Trust, said: 'If it's COVID-19 or not is to be seen.' 

But he added: 'It is a phenomena paediatric intensive care units [are] seeing across [the] UK at the moment, and I also hear from other international centres.' 

Another paediatric - Dr Damian Roland - admitted that he had 'no idea' what 'blood parameters consistent with severe COVID-19' meant.

Dr Roland, chair of the Paediatric Emergency Research in the UK and Ireland, said it implied all children with abdominal pain are at risk.

He tweeted: 'This is not based on any evidence and I hope they amend [the] alert as soon as possible.' 


Dr Colin Dunkley, a paediatrician at the Sherwood Forest Hospitals NHS Foundation Trust, replied to the PICS tweet: 'Anything more specific you can say?'

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