In England, Italy, but also in France, an unusual influx of children admitted to intensive care for severe inflammations of the heart tissue and coronary arteries has led pediatricians to issue an alert. Doctors are surprised by this abnormal influx of young patients, some of whom test positive for Covid-19. Health Minister Olivier Véran said he was worried but vigilant about this situation, when schools should reopen in a few days.
The first one urgent alert was launched on April 27 by British doctors concerned that ” rare but dangerous reaction in children, which may be linked to a coronavirus infection ” The medical director of the NHS, the English health system, Stephen Powis, said he was aware of reports of rare and serious illnesses in children. ” It’s only in the last few days that we’ve seen these reports. We asked our experts to urgently review the situation “He told the BBC.
At the same time, an unusual influx of young patients led the heads of French pediatric resuscitation departments to question themselves. Then to exchange. Three major Paris departments have identified at least fifteen cases of myocarditis, that is to say inflammation of the muscle tissue of the heart, which lead to heart failure, in young patients. ” At Trousseau Hospital, we found three in ten days, against two or three per year usually “Explains Professor Pierre-Louis Léger, head of the pediatric resuscitation department at Trousseau Hospital (AP-HP) at BFM. ” In Necker, it’s more than a dozen and at Robert Debré hospital, three or four “He continues. ” Suffice to say a totally abnormal assessment in this period “
In addition to British and French doctors, their Italian counterparts have also observed similar syndromes in Bergamo, the center of the epidemic on the peninsula. Findings joined by Spanish and Swiss pediatricians.
Health alert
This situation led the five Ile-de-France pediatric resuscitation services to issue an alert to health authorities on Monday, April 27. Then learned societies, including the French Society of Pediatrics, the French-speaking Society of Rheumatology and Pediatric Internal Medicine, sent an alert to health professionals on Wednesday April 29.
The Rare Disease Center for Congenital Heart Defects identifies at least 25 cases in three weeks in the Parisian intensive care unit, ” including nine just in Necker over the past two days. ” The Center mentions “an increasing number of children of all ages (…) hospitalized in a context of multi-systemic inflammation frequently associating circulatory failure with elements in favor of myocarditis “
According to Professor Léger interviewed by BFM journalists, the first eight patients are between 8 and 15 years old. Those of Professor Dauger, less than 10 years old. Most have no co-morbidity, that is, preexisting disease. Often, young patients presented with digestive signs, fever, and then a state of respiratory shock. ” It looks like viral myocarditis or Kawasaki disease, an inflammatory disease, without being one because this disease is common in younger children (generally less than 5 years old) and the picture is not typical; that is, not all symptoms stick together Analyzes Professor Léger.
Also according to this doctor, the majority of children have tested positive for Covid-19, either by diagnostic test or by serological test. That is, they have antibodies showing that they have been previously infected, often without symptoms.
Incomprehensible influx
Doctors do not understand the influx of young patients to Paris when the coronavirus epidemic in this region is on the wane. They suspect a delayed effect of the contamination. The children are said to have been infected and to have developed low-noise inflammatory syndromes, which went unnoticed, which worsened afterwards. The surprise is all the greater since, so far, the epidemic seems to have spared the children. Indeed, according to the latest epidemiological bulletin from Public Health France, those under 14 years of age represent less than 1% of hospitalizations for Covid-19. As of April 21, of the 5,405 patients admitted to intensive care, 26 were under 14 years of age.
Children admitted to emergency rooms in recent days suffer from abdominal pain, diarrhea and vomiting, then fever; doctors then discover heart inflammation and a significant respiratory syndrome. In addition, all children recently admitted to hospitals are not positive for Covid-19 according to PCR tests. In Trousseau, the doctors treated a child who was not positive by PCR test but who presented all the signs of Covid-19 on the scanner.
Scientists like Professor Dauger, head of the pediatric resuscitation department at Robert-Debré Hospital, believe that there must be a correlation with Covid-19, but the direct relationship and the physiological mechanism are not yet known. He confides his doubts to the newspaper Le Monde: ” We are left with question marks. Is it a direct attack of the virus? or post-infectious reactions, abnormal immune response? It is not documented at this time. “
While the Prime Minister announced on April 28 the opening of schools for children from May 11, the Minister of Health wants to be reassured by this news. ” I take it very, very seriously. We have absolutely no medical explanation at this point. The fact remains that children remain unaffected by Covid-19 and do not intend to question the reopening of schools to date.
It is true that doctors want to be reassuring. Professor Léger specifies that ” The evolution of the treated patients is rather favorable, even if it requires a stay in intensive care, and drugs to support the heart ” He adds a positive note: ” For the three patients in my department at Trousseau, all have recovered ” ” Parents must be reassured, these are rare cases which do not call into question the fact that children are less prone to severe forms, and are undoubtedly less carrier, less vector than adults “Adds Professor Dauger from Robert Debré Hospital.
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