Many children are "weird disease", the new crown virus is really "the culprit"?

Click [medical side] to pay attention to us. At the end of December 2019, Wuhan first publicly reported the occurrence of "unexplained pneumonia". The novel coronavirus was confirmed by novel coronavirus pneumonia by. The disease was named as "Coronavirus Disease 2019" (COVID-19).novel coronavirus pneumonia is being refreshed with the deepening of scientific research, but the true face of new crown pneumonia is far from that., novel coronavirus pneumonia, has been in an orderly way with the domestic epidemic situation continuing to improve. However, the recent news about the Kawasaki disease caused by the new crown pneumonia has made everyone nervous again.then, what is Kawasaki disease? Kawasaki disease (KD), also known as mucosal lymph node syndrome, is an acute, febrile, rash disease that often occurs in infants under 5 years old, and belongs to an inflammatory disease.it is reported that many children with Kawasaki disease symptoms have been diagnosed.they have varying degrees of high fever, rashes all over the body, abnormal cardiopulmonary breathing, crying constantly, and some of them have diarrhea and can't eat.the main characteristics of Kawasaki disease are not only children. Recently, covid-19 has been reported to cause multiple skin lesions in adults in J am Acad dermatol (Official Journal of American Society of Dermatology) and j EUR Acad dermatol venereol (Official Journal of European Society of Dermatology and venereol).it is not difficult to see that the new coronavirus affects people more than fever, cough, anorexia, dyspnea and other common symptoms., novel coronavirus pneumonia, is especially worthy of attention in the field of autoimmune diseases and inflammatory diseases.6 4 novel coronavirus pneumonia Reviews Nature (Reviews) (Nature): a report entitled Autoimmune and inflammatory and, was published in detail.literature interpretation 1 research status PIMS: pediatric inflammatory multisystem syndrome, also known as children's multi system inflammatory syndrome (mis-c), including Kawasaki like childhood disease, Kawasaki disease shock syndrome, toxic shock syndrome, myocarditis and macrophage activation syndrome.data 1 as of 12 may 2020, the European Center for Disease Control and prevention has reported 224 cases of PIMS throughout Europe.from a study team in Bergamo, Italy, described the incidence rate of Kawasaki disease increased by 30 times, and reported 10 cases of Kawasaki disease, 8 of whom were positive for IgG or IgM of SARS-CoV-2.in London, UK, eight children suffered from highly inflammatory shock, which was similar to atypical Kawasaki disease, Kawasaki shock syndrome or toxic shock syndrome.the eight children were all positive for sars-cov-2 antibody.in the report issued on May 14, 2020, the French national public health agency recorded 125 cases of atypical PIMS between March 1 and May 12, 2020; so far, 65 children with sars-cov-2 were positive.a detailed investigation of some of these cases, including a study of 17 patients in the Paris area and a retrospective study of 35 patients in 12 French and a Swiss medical centers, showed that, in addition to gastrointestinal symptoms, rashes, cervical lymphadenopathy, cheilitis and high levels of inflammatory markers, myocardial involvement were common.many patients show incomplete Kawasaki disease.data 3 in the United States, the New York City Department of Health reported in May 4, 2020 that 15 children aged 2 to 15 years showed mis-c symptoms, including persistent fever and elevated levels of inflammatory markers, as well as rashes, abdominal pain, vomiting or diarrhea; 10 of the 15 children were positive for sars-cov-2 infection.by May 12, 2020, the number of suspicious mis-c cases has increased to 102.2 characteristics of kd-covid-19. The above studies showed that the symptoms of PIMS related to covid-19 overlapped with Kawasaki disease, but the affected patients also showed symptoms unrelated to Kawasaki disease.therefore, it is important to distinguish between classic Kawasaki disease and covid-19 related Kawasaki disease.Italian pediatricians have noticed that compared with the classic Kawasaki disease, kd-covid-19 patients tend to have the following characteristics: (1) kd-covid-19 patients are older, with gastrointestinal and meningeal signs. (2) patients with kd-covid-19 have leucopenia accompanied by lymphocytopenia, thrombocytopenia, elevated ferritin and markers of myocarditis. (3) patients with kd-covid-19 are more severe and often hospitalized in ICU.3 onset period (1) PIMS in children may occur in the late stage of covid-19. The clinical history of PIMS patients shows that many people have previously experienced mild symptoms of covid-19 or had contact with covid-19 positive family members.in the French study, the median time between covid-19 symptoms and PIMS symptoms was 42 days (range, 18-79 days).therefore, most PIMS patients are positive for sars-cov-2 IgM or IgG when the symptoms of autoinflammation appear.IgG usually appeared about 2 weeks after primary infection, indicating that PIMS was delayed after primary infection.however, several PIMS patients had positive nasopharynx and oropharyngeal swabs for sars-cov-2, indicating that PIMS may even occur in the late stage of covid-19.(2) autoimmune symptoms of adult patients mostly occur in the early stage of covid-19. In adults, the range of complications caused by covid-19 is more extensive than that of children, including autoimmune diseases, but its incidence is very rare.it has been reported that three patients with idiopathic thrombocytopenic purpura, Guillain Barre syndrome and autoimmune hemolytic anemia were found to be infected with covid-19 after 4-13 days.therefore, compared with PIMS, autoimmune symptoms in adult patients appear in the early active phase of covid-19.4 causality although the causal relationship between sars-cov-2 and autoimmune and inflammatory diseases has not been firmly established, it is related to the time of the current covid-19 pandemic and the exposure of affected patients to sars-cov-2. the authors propose two possibilities: sars-cov-2 can directly cause autoimmune and / or inflammatory diseases. in order to confirm this hypothesis, the homology between sars-cov-2 antigens and their own antigens can be analyzed by computer methods and experimental models. ❷ sars-cov-2 infection may cause other environmental damage, which may cause autoimmune and / or autoimmune diseases in susceptible individuals. reports from the UK and France indicate that PIMS is more frequent in patients of African Caribbean origin. has not been reported in Asian countries (the incidence rate of Kawasaki disease is usually the highest), suggesting that genetic susceptibility may be a factor in the occurrence of KD-COVID-19 in . 5 treatment strategy: ① intravenous immunoglobulin (IVIG) treatment: the current report shows that the autoimmune and inflammatory disease spectrum of sars-cov-2 infected population is the most sensitive to intravenous immunoglobulin (IVIG). however, resistance to IVIG is more common in kd-covid-19 than in classic Kawasaki disease, and adjuvant steroids are required. ② IL-6 immunotherapy: studies have reported that three children in Switzerland have successfully received the treatment of IL-1 receptor antagonist anakinra; in addition, immunotherapy for IL-6 has also produced a good response in adults with severe covid-19. therefore, we suggest that tocilizumab (humanized monoclonal antibody) or sarilumab (complete human monoclonal antibody) can also be used to block IL-6 receptor in PIMS patients to inhibit IL-6 signal transduction in PIMS. novel coronavirus pneumonia is a new disease. Nip in the bud, novel coronavirus pneumonia, is not a bad thing for children or adults. No matter how crafty the virus is, we can prevent ourselves from being unprepared. we should also reserve more popular science knowledge about diseases, so as not to be frightened by the terrible news on the Internet. of course, we can't avoid medical care. When we find out that our body is unwell or abnormal, we should see a doctor in time. Early detection and early treatment are responsible for ourselves and the lives of others. the "medical side" is now officially open to the fans! The content must be original and published, and it is related to scientific research. Once it is adopted, it will be paid a lot (300-2000 yuan). Please stamp the details. 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