References
COVID-19 complications in children
Cases of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have increased dramatically since December 2019 evolving into the current COVID-19 pandemic. Adults, in particular the elderly, constitute the majority of cases and, overwhelmingly, of fatalities. A small proportion of cases have been children and young people, and generally manifestations in children are mild, with few complications and deaths reported (Ahmed et al, 2020). During the early stages of the pandemic, an unusual constellation of clinical manifestations, now called multisystem inflammatory syndrome in children (MIS-C), was recognised in small numbers of young patients. MIS-C was noted to be temporally related to COVID-19 and presented around 3-4 weeks after acute SARS-CoV-2 infection; a causal link has yet to be confirmed (Ahmed et al, 2020). The clinical manifestation of MIS-C includes shock and multisystem dysfunction, occasionally leading to death. There is significant clinical overlap with other widespread, severe conditions, such as Kawasaki disease and toxic shock syndrome, potentially creating diagnostic difficulty (Ahmed et al, 2020). The typical presenting symptoms of MIS-C are fever, rash, abdominal pain, diarrhoea and vomiting. Low blood pressure, shock, and cardiac abnormalities are common physical signs. Laboratory investigations usually show abnormal blood findings suggestive of severe inflammation—including high neutrophil count, elevated C-reactive protein and low lymphocyte count (Ahmed et al, 2020; Swann et al, 2020).
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