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expert reaction to case definition for illness affecting children during COVID-19

Case definitions or illness affecting children during COVID-19 have been published by the Royal College of Paediatricians and Child Health (RCPCH).


Prof Rosalind Smyth, Director and Professor of Child Health, UCL Great Ormond St Institute of Child Health, said:

How common is this illness? Is it common for certain illnesses like this to only to affect children?

“This advice is directed towards clinicians, so that they can appropriately manage and refer children who may have this condition.  At the minute it seems that this condition is very rare.  One of the purposes of the current alerts and guidance is to increase awareness, so that all possible cases can be identified.  This will help to identify the true incidence.

How much do we understand (and not know) about its cause and mechanism? How will be able to work out if it is related to COVID-19 infection and who may be more susceptible?

“We know very little about the cause and mechanisms.  Indeed, our understanding of the mechanisms of the condition which it may resemble, Kawasaki’s syndrome, is incomplete.  Working out a possible relationship to COVID-19 will depend on testing for the virus, repeatedly during the course of the illness, and for the antibody, following recovery, to work out if there is a temporal relationship with SARS-CoV-2, in some, or all, cases.

What research needs to take place?

“We need to study children affected by this illness, as described above.  This will guide further research into mechanisms and susceptibility.

Does this significantly change our understanding of how COVID-19 may be affecting children?

“It remains the case that the great majority of children with COVID-19 have mild symptoms only.

Why could it be that this isn’t being reported in all countries, even in very small numbers?

“We don’t know the answer to this, but increasing awareness may increase reporting, in other countries.

Does this change any guidance on when parents should be concerned about the health of their child?

“Parents should always seek medical advice promptly if their child has a high fever and/or other concerning symptoms.  In other words, follow the normal advice, if their child is unwell.”


All our previous output on this subject can be seen at this weblink:


Declared interests

None received.

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