By Dato’ Dr Amar-Singh HSS
Children form a small proportion of those who have tested positive in this COVID-19 pandemic. In Malaysia, children aged 0-12 years comprised of 317 out of 6,872 cases identified (4.6%). Although children get infected with COVID-19 and transmit the disease, the vast majority generally do very well or remain asymptomatic; severe illness and death are rare. Older children and adolescents are infected in larger numbers and more likely to get significant illness.
Recently however there has been concern, as young children infected with COVID-19 have presented with a severe Kawasaki-like disease with some fatality.
The classical non-COVID-19 Kawasaki disease is an uncommon disease that usually affects very young children. It a ‘vasculitis’ in that it affects the blood vessels in the body with inflammation. The biggest concern is aneurysms that develop in the coronary arteries (blood vessels supplying the heart muscle with oxygen). Kawasaki disease is usually diagnosed by a prolonged fever, a rash, lymph node enlargement, redness of the conjunctiva, red lips/tongue, swelling/redness of the hands/feet and coronary artery aneurysms.
The first warnings came from the National Health Service of the UK at the end of April that described increasing numbers of very ill children with a ‘multi-system inflammatory state’. Now reports have appeared from other parts of Europe and the USA. All these children were either positive for COVID-19 or had serological markers (antibodies) to show that they had been infected.
The overall numbers of children with this severe Kawasaki-like disease are still small (the risk of this happening in infected children is very small) but it is of concern. It tells us that some very young children may be vulnerable to COVID-19 and stress the need for all of us to work together to limit its spread in any community.
We need to continue to maintain our focus on stopping COVID-19 spread by safe physical distancing, avoid touching faces, mask-wearing, preventing crowding, limit physical contact and talking, keep hands clean at all times, keep surfaces clean at all times. We also need to get a better idea of the risk of this severe Kawasaki-like disease (more data) before we consider opening our school, kindergartens, nurseries and child care centres.
Dato’ Dr Amar-Singh HSS is a Senior Consultant Paediatrician and former Head of Paediatric Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak. He also formerly served as a Head of Clinical Research Center in Perak.
* This is the personal opinion of the writer or publication and does not necessarily represent the views of Science Media Centre Malaysia
**All previous posts about COVID-19 here: https://sciencemediacentremalaysia.com/tag/covid-19/