An eleven-year-old girl has died from organ failure in Spain after suffering from a Kawasaki-like disease linked to the coronavirus, according to local media.
The child, who had no known underlying health conditions, passed away at the Joan XXIII University Hospital of Tarragona in Catalonia yesterday after testing positive for Covid-19.
Catalonia’s public health secretary claimed it was too early to say Covid-19 was definitely the cause of death, adding that it was ‘a very sad case’.
But the girl’s case had all of the hallmarks of the Covid-linked disease, which has been dubbed Paediatric Inflammatory Multisystem Syndrome Temporally (PIMS-TS).
The condition appears to strike children around the age of 10, on average, typically causing stomach pains, vomiting, diarrhoea, fevers, rashes, red eyes and swollen feet.
Fatal complications of the illness appear to be related to the strain it puts on the heart – but the exact details of how the condition kills remain unclear.
Doctors are almost certain the illness is being caused by the coronavirus but they haven’t yet been able to prove it yet.
At least two British children have died from the condition and hundreds have been hospitalised.
The child, who had no underlying health conditions, passed away at the Joan XXIII University Hospital of Tarragona in Catalonia (pictured) yesterday after testing positive for Covid-19
In the largest study of its kind yet, paediatricians detailed the course of the mystery inflammatory illness in 78 hospitalised youngsters. The most common symptoms were fever, shock, abdominal pain, vomiting and diarrhoea. Other reported symptoms by other doctors are a rash (see bottom right, in different skin colours), red eyes, a headache, swollen hands and feet and confusion
The Spanish girl was initially admitted to the Verge de la Cinta Hospital in Tortosa over the weekend, according to regional newspaper Diario de Tarragona.
It’s unclear what her initial symptoms were, but her condition is said to have deteriorated rapidly.
The child was then transferred 50 miles to the Joan XXIII early on Monday morning when her organs started to fail.
Secretary General of Public Health, Mr Argimon,said the girl had been diagnosed with Covid-19, but , for the moment, it was not possible to know if the virus was the cause of the death. ‘You have to differentiate the two things well,’ said Argimon. ‘It it is a very sad case.’
There have been fewer than 200 cases of PIMS-TS reported in England so far, with a range of symptoms and severity. Most children have already recovered.
Nearly 300 cases the life-threatening syndrome have been identified in the US, in two studies published in The New England Journal of Medicine.
The illness has been likened to Kawasaki disease, which mainly affects under-fives and causes blood vessels throughout the body to swell.
Children appear to fall sick with PIMS-TS several weeks after being infected by the coronavirus, called SARS-CoV-2.
In April, clinicians in the UK were alerted to a cluster of children with unexplained inflammation requiring admission to intensive care units.
A major study was carried out over 40 days and 78 cases of PIMS-TS were reported by 21 of 23 intensive care units in the UK. Two of the chidren died.
The full findings were published in the medical journal, The Lancet, last month.
The study said hospital admissions to paediatric intensive care between April 1 and May 10 was at least 11-fold higher than historical trends for similar inflammatory conditions.
Dr Patrick Davies, consultant paediatric intensive care specialist at Nottingham Children’s Hospital, published the findings of 78 children across 21 of 23 UK paediatric intensive care units during that time period.
They each fulfilled the condition definition newly outlined by the Royal College of Paediatrics and Child Health to help both doctors and parents spot the signs.
A fever was present in all cases studied, and children also suffered with shock, abdominal pain, diarrhoea and vomiting.
They received a varied range of treatments, and one child was given the antiviral remdesivir – which became the first medication to get approval for use on the NHS to treat Covid-19 in May.
A third of patients were found to have coronary artery abnormalities. These included coronary aneurysms – the abnormal dilation of a artery supplying the heart.
Four per cent of patients had significant blood clotting that was affecting the blood flow in vessels.
Doctors believe the survival rate is high because three per cent (two) of children in the study died.
Dr Padmanabhan Ramnarayan, senior author of the research, told MailOnline: ‘While it is difficult to comment about the cause of death in individual cases, potential mechanisms for a poor outcome might include blood clots in the brain, excessive bleeding and severe heart failure.
‘However, this study shows that the condition is rare and has affected few children overall, and that outcomes for those who have needed ICU care is generally very good.’
He added that PIMS-TS is an inflammatory condition and causes a similar phenomenon to the ‘cytokine storm’ described in adults with Covid-19.
A cytokine stormy, potentially fatal, is when the immune response goes into overdrive and immune cells start attacking healthy tissue as well.
Dr Ramnarayan, a consultant in paediatric intensive care retrieval at Great Ormond Street Hospital, said: ‘[It] may lead to multiple organs being affected, mainly the heart, kidneys and blood vessels.’
Academics did not reveal who the children who died in the study cohort were. It is not clear they are two previously reported UK fatalities linked to Kawasaki and Covid – a 14-year-old boy and an eight month old baby.
The death of the unnamed 14-year-old boy, treated at Evelina London Children’s Hospital in May, was reported on May 13. He had been part of a cluster of cases of PIMTS at the hospital.
The baby, Alexander Parsons, who had no underlying health conditions, passed away after being admitted to Plymouth’s Derriford Hospital on April 6.
He had been diagnosed with Kawasaki disease the day of his death and suffered a ruptured aneurysm, but it is not clear if his case was linked with Covid-19, his parents said.
Dr Ramnarayan said clinicians across the world have already made tremendous progress in understanding PIMS-TS, The Sun reports.
‘However, many aspects of the condition remain unclear, such as why it only affects some children or what the long-term implications of having this condition are,’ he added.
Dr Barney Scholefield, senior author, said a wealth of information to help treat cases has been uncovered so far.
‘A large group of children’s intensive care clinicians from across the NHS have rapidly worked together to help understand this condition,’ the paediatric intensive care consultant at Birmingham Women’s and Children’s NHS Foundation Trust and researcher at the University of Birmingham said.
Lead researcher on the paper and consultant paediatric intensive care specialist at Nottingham Children’s Hospital, Dr Patrick Davies said the key to successful treatment is ‘close collaboration with many specialists’.