▲全球視野 本土思考
★專業/深度/睿見資訊盡在醫療旅遊
英國兒科專家警告說，越來越多的兒童患有一種可能與冠狀病毒有關的罕見症候群。
近日，英國兒科重症監護學會（PICS）警告說，危重兒童的病例數有所增加，其中一些兒童Covid-19檢測呈陽性，呈現出「毒性休克症候群和非典型川崎病與血液參數的重疊特徵」。
在近日發給照顧重症兒童的醫療專業人員的一份聲明中，PICS說：「腹痛和胃腸道症狀與心臟炎症一樣是常見的症狀。」
什麼是川崎病？
川崎病，也稱為川崎綜合症，是一種罕見的兒童疾病，會導致體內血管壁發炎。
根據英國國家衛生局（NHS）的說法，這種疾病（也稱為皮膚黏膜淋巴結症候群）主要影響5歲以下的兒童，儘管它可以影響任何年齡段的兒童。
該病症狀包括持續五天或更長時間的高溫，以及皮疹，頸部腺體腫脹，嘴唇乾裂，手指或腳趾發紅和眼睛發紅。
NHS說，如果得到治療，症狀通常會變得不那麼嚴重，並補充說這種疾病不會傳染。
NHS全國兒童和青少年臨床主任Simon Kenny教授在一份聲明中說：謝天謝地，川崎病是非常罕見的，因為目前兒童的嚴重併發症與Covid-19有關，但是重要的是，臨床醫生要知道任何潛在的新出現的聯繫，以便他們能夠給兒童和年輕人迅速正確的治療。
可能導致心臟併發症的疾病
據梅奧診所稱，川崎病是美國後天性心臟病的主要原因，嚴重的併發症可能包括動脈瘤和冠狀動脈擴張。
美國疾病控制與預防中心（CDC）說，標準治療包括靜脈注射免疫球蛋白和阿司匹林，可以顯著減少冠狀動脈畸形的發生。
根據NHS的數據，大約25％的未接受治療的兒童會出現心臟併發症，其中可能包括心臟病發作和心臟病。大多數川崎病患兒如果得到及時治療，即可完全康復。
什麼原因導致川崎病？
專家們承認，川崎病的病因尚未完全明了，但他們認為患川崎病的兒童可能是遺傳遺傳易感者，並從父母那裡遺傳了某些基因。
根據NHS，該疾病本身並不具有傳染性，這意味著它不太可能是由病毒單獨引起的。
NHS說，這種疾病在東北亞的兒童中更常見，尤其是在日本和韓國。
與Covid-19有什麼聯繫？
川崎病和Covid-19之間的聯繫尚不清楚，但醫生已向父母們保證，兒童感染該病毒重症的風險仍然很低。
在四月份發布的一份報告中，疾病預防控制中心表示，在美國被診斷為冠狀病毒的兒童通常為輕微的冠狀病毒病例。
根據疾病預防控制中心的數據，兒童中的Covid-19病例數量仍然很少，雖然一些兒童和嬰兒患了Covid-19，但迄今為止，成人佔大多數已知病例。
加州大學大奧蒙德街兒童健康研究所兒童保健主任兼教授Rosalind Smyth教授說，目前的證據表明，大多數接受過Covid-19治療的兒童都有輕微症狀，其中約一半發燒，約40％咳嗽，有胃腸道症狀的報導病例不到10％。
Smyth在一份聲明中說：「但是，我們對兒童這種病的了解有限。在成人中，Covid-19確實是一種影響許多器官的炎症性疾病。我們應該對這些患SARS-CoV-2的兒童進行全面調查，他們會出現一種多系統炎性疾病，以評估這是否是Covid-19的表現。」＊
What is Kawasaki disease? The rare child syndrome might have link to Covid-19
tUK paediatrics specialists have warned that a small but rising number of children are becoming ill with a rare syndrome that could be linked to coronavirus.
On Sunday the Paediatric Intensive Care Society UK (PICS) warned about a small rise in the number of cases of critically ill children, some who had tested positive for Covid-19, presenting "overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters."
In a statement sent over the weekend to medical professionals who look after critically ill children, PICS said "abdominal pain and gastrointestinal symptoms have been a common feature as has cardiac inflammation."
So what is Kawasaki disease and how worried should parents and carers be?
What is Kawasaki disease?
Kawasaki disease, also known as Kawasaki syndrome, is a rare childhood illness that causes the walls of the blood vessels in the body to become inflamed.
According to the UK's National Health Service (NHS), the condition -- also known as mucocutaneous lymph node syndrome -- mainly affects children under the age of 5, although it can affect children of any age.
Symptoms include a high temperature lasting for five days or longer, alongside a rash, swollen glands in the neck, dry cracked lips, red fingers or toes and red eyes, according to the healthcare provider.
If treated, the symptoms usually become less severe, the NHS said, adding that the disease is not contagious.
"Thankfully Kawasaki-like diseases are very rare, as currently are serious complications in children related to Covid-19, but it is important that clinicians are made aware of any potential emerging links so that they are able to give children and young people the right care fast," Professor Simon Kenny, NHS national clinical director for children and young people said in a statement sent to CNN on Monday.
A condition that can lead to heart complications
Kawasaki disease is a leading cause of acquired heart disease in the United States, and serious complications can include aneurysms and coronary artery dilations, according to US healthcare company the Mayo Clinic.
Standard treatment, which involves intravenous immunoglobulin and aspirin, can substantially decrease the development of coronary artery abnormalities, the US Centers for Disease Control and Prevention (CDC) says.
According to the NHS, around 25% of children with the disease who do not receive treatment go on to experience heart complications, which can include conditions such as heart attacks and heart disease.
However, the health care provider says that most children with Kawasaki disease make a full recovery if they receive prompt treatment.
What causes Kawasaki disease?
Experts admit that the causes of Kawasaki disease are not fully understood, but think that children who develop it could be genetically predisposed to it, having inherited certain genes from their parents.
The disease itself is not contagious, according to the NHS, meaning that it is unlikely to be caused by a virus alone.
The disease is more common in children from Northeast Asia, especially Japan and Korea, the NHS said.
What is the link to Covid-19?
The link between Kawasaki disease and Covid-19 is unclear, but health care professionals have reassured parents that the risk of children becoming severely ill with the virus remains low.
In a report released in April, the CDC said that children diagnosed with coronavirus in the US typically have mild cases of the virus.
The number of Covid-19 cases among children remains small and while some children and infants have been sick with Covid-19, adults make up most of the known cases to date, according to the CDC.
Professor Rosalind Smyth, director and professor of child health, UCL Great Ormond St Institute of Child Health, said current evidence suggests that most children with Covid-19 who receive medical attention have mild symptoms, with about half having a fever, around 40% having a cough and less than 10% of reported cases having gastrointestinal symptoms.
"However, our understanding of this condition in children is limited. Covid-19 does present, in adults, as an inflammatory disease affecting a number of organs. We should investigate fully these children, with SARS-CoV-2, who present with a multi-system inflammatory disease to assess whether this is a presentation of Covid-19," Smyth said in a statement Monday.avel