New study looks at post-COVID-19 emerging disease in children

Date:
June 25, 2020
Source:
Radiological Society of North America
Summary:
In recent weeks, a multisystem hyperinflammatory condition has
emerged in children in association with prior exposure or infection
to SARS-CoV-2. A new case series examines the spectrum of imaging
findings in children with the post-COVID-19 inflammatory condition
known in the US as Multisystem Inflammatory Syndrome in Children
(MIS-C).



FULL STORY ==========================================================================
In recent weeks, a multisystem hyperinflammatory condition has emerged in children in association with prior exposure or infection to SARS-CoV-2. A
new case series published in the journal Radiology examines the spectrum
of imaging findings in children with the post-COVID-19 inflammatory
condition known in the U.S. as Multisystem Inflammatory Syndrome in
Children (MIS-C).


==========================================================================
The array of findings includes airway inflammation and rapid
development of pulmonary edema, coronary artery aneurysms, and extensive intra-abdominal inflammatory changes.

In April 2020, Evelina London Children's Hospital in London, U.K.,
experienced a surge of children with a multi-system hyperinflammatory
syndrome. The children had a variety of symptoms, including fever,
headaches, abdominal pain, rash and conjunctivitis. Clinical features
and lab findings shared some similarities to those of Kawasaki
disease -- which causes inflammation in the walls of blood vessels -- Kawasaki-disease shock syndrome or toxic-shock syndrome, although atypical
and more severe.

"Our hospital saw an unprecedented cluster of children presenting with
MIS-C, a new hyperinflammatory syndrome in children related to the current COVID-19 pandemic -- the recognition of which led to a national alert,"
said the study's lead author, Shema Hameed, M.B.B.S., consultant pediatric radiologist at Evelina London Children's Hospital.

For the study, researchers performed a retrospective review of clinical, laboratory and imaging findings of the first 35 children under age 17
who were admitted to the pediatric hospital that met the case definition
for MIS-C. The children were admitted from April 14 to May 9, 2020,
and included 27 boys and eight girls, with a median age of 11 years old.

The most common clinical presentation was fever, found in 33 (94%)
of the children, gastrointestinal symptoms including abdominal pain,
vomiting and diarrhea in 30 (86%) of the children, rash (13 or 37%)
and conjunctivitis (9 or 26%). Twenty-one children (60%) were in
shock. Clinical status was severe enough to warrant management in the
pediatric intensive care unit in 24 of 35 children (69%), of which 7
(20%) required mechanical ventilation and 20 (57%) inotropic support.



==========================================================================
Two children required extracorporeal membrane oxygenation (ECMO) due
to severe myocardial dysfunction. Lab tests revealed that all of the
children had abnormal white blood cell counts.

The study identified a pattern of imaging findings in post COVID-19 MIS-C, including airway inflammation, rapidly progressive pulmonary edema,
coronary artery aneurysms and extensive abdominal inflammatory changes
within the right iliac fossa.

All 35 children underwent chest X-ray due to fever, sepsis or features
of multisystem inflammation. Nineteen X-rays were abnormal, the most
common finding being that of bronchial wall thickening.

The predominant findings on chest CT were basal consolidation, or part of
the lung filling with fluid; and collapsed lung with pleural effusions,
or build-up of fluid in the outer membranes of the lungs.

Abdominal ultrasound findings included inflammatory changes within the
right iliac fossa, with mesenteric fat stranding, lymphadenopathy and
bowel wall thickening, as well as free fluid in the pelvis.

"As pediatric radiologists, we were interested in the emerging pattern
of imaging findings that we observed in these children," Dr. Hameed
said. "Our intention is to bring these findings to the attention of
the wider radiological community." The authors advise that future
studies should include a larger group of patients, ideally utilizing multi-center databases to assess the radiological findings alongside
the complex clinical course of these young patients.


========================================================================== Story Source: Materials provided by
Radiological_Society_of_North_America. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Shema Hameed, Heba Elbaaly, Catriona E. L. Reid, Rui M. F. Santos,
Vinay
Shivamurthy, James Wong, K. Haran Jogeesvaran. Spectrum of Imaging
Findings on Chest Radiographs, US, CT, and MRI Images in Multisystem
Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19.

Radiology, 2020; 202543 DOI: 10.1148/radiol.2020202543 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200625140719.htm

--- up 22 weeks, 2 days, 2 hours, 34 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1337:3/111)