The news worries at most to a few days of the resumption of school for toddlers. An alert left this weekend from England and broadcast in France on Monday, reports several cases of children hospitalized for an inflammatory disease, called "Kawasaki disease". In the midst of the Covid-19 epidemic, specialists suggest a "possible" link with the virus, which is not yet proven.
Like its English counterpart before it, the French Pediatric Society this Wednesday relayed several alerts to the attention of experts. “We have been challenged for several weeks by the description of pediatric cases in resuscitation of myocarditis with circulatory failure. We have also noticed […] a resurgence of atypical Kawasaki disease without heart failure, ”writes the French-speaking group of pediatric resuscitation and emergencies (GFRUP).
Behind these scientific descriptions, some doctors in France - as in the United States, Spain or Belgium - note the increasing arrival in pediatric services of children with digestive, respiratory or infectious symptoms, evoking an atypical form of the disease from Kawasaki. Directly linked to Covid-19?
Twenty cases identified in Paris hospitals
"The association of these cases with SARS-CoV2 is possible, even if it could not be proven for all patients," recall the pediatricians. "For the moment, these are alerts and reports intended for the medical community which are not intended to be disseminated to the general public without further explanation or solid argument", underlines Nhân Pham- Thi pulmonologist, pediatrician and allergist.
Quickly rumored, the information has in any case aroused concern, especially since all studies have so far shown that the serious forms of Covid-19 were extremely rare in the youngest. How many children could be affected? In hospitals in Paris, around twenty cases have been identified according to Damien Bonnet, head of pediatric cardiology service at Necker Hospital for sick children, who does not exclude other cases elsewhere. "Is this a significant signal? It is in any case perhaps the beginning of a closer relationship between the virus and this pathology. We can imagine multiple hypotheses: a favorable genetic background, the mutation of the virus, or even a specific late inflammatory syndrome ...? Answers Nhân Pham-Thi.
"All the pediatricians, resuscitators (in Europe) work together to see whether or not there is a need to make a link with the Covid-19, which I do not know yet when I speak to you", recalled for his part the French Minister of Health, Olivier Véran, this Wednesday at the National Assembly.
A pathology "well known" to doctors
Several indices indeed put pediatricians on the trail of a cause and effect link between the coronavirus and these inflammatory symptoms, in particular the famous cytokine storm. “What we do know is that in cases of Covid-19, there can be respiratory, digestive or neurological damage, this involves inflammation via the small blood vessels. In the case of Kawasaki syndrome, it is a diffuse inflammatory phenomenon of the small vessels, as if the blood vessels "caught fire". There is a runaway immune system. We know that the Covid 19 would be capable of generating explosions of this kind, ”notes Nhân Pham-Thi. But there are also several signs to put things into perspective. "There are sometimes waves of cases at certain times, often linked to infections," said Nhân Pham-Thi.
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VIDEO. Olivier Véran: "15 children in France" have symptoms resembling Kawasaki disease
This pathology is in any case "well known" to doctors, and does not cause any particular concern. "It has rare vascular complications, we generally cure it well with good monitoring," notes the pulmonologist. "The first epidemic wave has already mainly occurred and few children have been hospitalized," notes Robert Cohen, pediatrician and infectious disease specialist at the Créteil inter-communal hospital (Val-de-Marne).
“It is normal for each medical specialty to forward information as soon as something happens about the Covid. Thousands of publications are made in medicine on this subject. But in our eyes, this is not a worrying phenomenon as it stands. All our data show that there are really very few serious cases of Covid in children, ”notes Jean-Daniel Lelièvre, head of the infectious diseases department at Henri Mondor hospital (AP-HP).
