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Blood test could diagnose new Covid-linked inflammatory disease in kids, docs hope

A BLOOD test could diagnose the new “inflammatory syndrome” in kids linked to coronavirus, doctors say.

Medics have recently seen a rise of children developing a condition similar to toxic shock syndrome (TSS) and Kawasaki disease, a disorder that causes inflammation to the heart.

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 A blood test could diagnose the new 'inflammatory syndrome' in kids linked to coronavirus
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A blood test could diagnose the new 'inflammatory syndrome' in kids linked to coronavirusCredit: Getty Images - Getty

But now UK researchers are hopeful that blood markers may help them identify those most at risk from the mysterious illness.

It comes as about 100 children in Britain have been treated for the disease, which causes persistent fever, skin rashes, abdominal pain and cold hands or feet.

Researchers at Imperial College London analysed blood from some of the sickest children with the condition.

And they found each of the children had high levels of five compounds that can be measured in routine tests.

Routine tests

Two of the compounds, ferritin and C-reactive protein or CRP, are common blood markers for inflammation.

The others are linked to heart damage and blood clotting, namely troponin, BNP and so-called “D-dimers”.

Michael Levin, a professor of paediatrics and international child health at Imperial, told The Guardian: "We know that these markers are present in the very sick patients and at lower levels in some patients with normal Kawasaki disease.

"We think they can help us decide which children are at risk of progressing to cardiac failure.

"Essentially what we’re doing is using the blood markers to try and pick out the children that we need to move from district hospitals to specialist centres and then to intensive care units if needed."

We think they can help us decide which children are at risk of progressing to cardiac failure

Michael LevinProfessor of paediatrics and international child health at Imperial

Despite this, the researchers will need to carry out further studies to work out if the markers are reliable.

If they are, doctors could potentially identify children most at risk from the condition with a simple blood test.

The researchers have been given permission from Professor Chris Whitty, England’s chief medical officer, to recruit children into a European-funded trial called Diamonds that was already underway to study inflammatory disorders.

Doctors across the country and in various hospitals in Europe are now collecting blood samples for the study to learn which markers may help them predict the severity of disease and to understand the genetics of the disorder.

 The effects of the illness have been seen in children both with and without coronavirus
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The effects of the illness have been seen in children both with and without coronavirus
 Children affected display signs similar to toxic shock syndrome
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Children affected display signs similar to toxic shock syndrome

Prof Levin added that because doctors are now seeing "quite significant numbers of children" with the disease, medics need to learn how to manage it.

Professor Russell Viner, the president of the Royal College of Paediatrics and Child Health, said it was too early to know how successful blood biomarkers might be for identifying kids with the new inflammatory disease.

He said: "If Covid is going to be with us for a while, and there’s going to be a rise in Covid cases, we are going to see more of these cases.

"So we absolutely need ways of identifying early on which children might have this as opposed to a child who just presents with a fever, so biomarkers might be exceptionally helpful in the longer term.”

The new syndrome emerged last month, with UK health officials warning of "a multi-system inflammatory state, requiring intensive care across London and also in other regions of the UK".

We absolutely need ways of identifying early on which children might have this

Professor Russell VinerPresident of the Royal College of Paediatrics and Child Health

The Paediatric Intensive Care Society issued the alert to the NHS, telling GPs: "There is growing concern that a [Covid-19] related inflammatory syndrome is emerging.

"Please refer children presenting with these symptoms as a matter of urgency."

Some, but not all kids with signs of this new condition have tested positive for coronavirus.

But, it’s not yet clear if there is a direct link with Covid-19.

Public Health England are investigating, as NHS England’s medical director Prof Stephen Powis said: “It is really too early to say whether there is a link.”

What are the symptoms the new 'inflammatory syndrome' in kids linked to coronavirus?

Health chiefs said in an alert to GPs the signs include:

  • Stomach pain
  • Gastrointestinal symptoms - like vomiting and diarrhoea

The mysterious condition has been compared to toxic shock syndrome (TSS) and Kawasaki disease.

The signs of TSS are:

  • High temperature
  • Flu-like symptoms, like headache, feeling cold, aches, sore throat and cough
  • Feeling and being sick
  • Diarrhoea
  • Widespread burn-like rash
  • Lips, tongue, and whites of the eyes turning bright red
  • Dizziness or fainting
  • Difficulty breathing
  • Confusion

Signs of Kawasaki disease include:

  • A rash
  • Swollen glands in the neck
  • Dry, cracked lips
  • Red fingers or toes
  • Red eyes

England’s Chief Medical Officer, Prof Chris Whitty added: “This is a very rare situation, but I think it is entirely plausible that it is caused by this virus, at least in some cases.

"We know that in adults who of course have much more disease than children do, big problems are caused by an inflammatory process."

Dr Sarah Jarvis, GP and clinical director of Patientaccess.com, told The Sun children can end up needing treatment in intensive care, and the illness could prove fatal in severe cases.

It’s been likened to Kawasaki disease, which cause inflammation to the heart and can lead to aneurysmsheart attack and heart disease.

Heart inflammation

In rare cases patients with Kawasaki disease can suffer internal bleeding if an aneurysm bursts.

Around 25 per cent of cases go on to experience heart complications, which can result in fatality in about two to three per cent of cases ,if not treated.

Dr James Gill, a GP and honorary clinical lecturer at Warwick Medical School, added: "Multi-system inflammatory diseases are exceptionally serious for children and already stretched intensive care teams, so keeping an extra eye out for new symptoms in the patients we see is always a good thing."

If you are worried your child could be suffering from the symptoms, it is important to seek medical advice, as soon as possible.

Contact your GP or call NHS 111.

Dr Jarvis told The Sun: "The NHS is very much open for business.

"If you have a child who is seriously unwell, you should call an ambulance – your child is much better off in hospital if they’re seriously unwell."

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