Most common manifestations are fever, diarrhea and skin problems; experts warn that ‘there is no reason to panic’, as there is a treatment protocol in Brazil
One of the countries with the highest daily contamination by Covid-19 in early 2021, the UK reported a large volume of cases of a “rare disease” related to the new coronavirus in children in the region in recent weeks. According to the newspaper The Guardian, a study under development in the European country shows that hospitalizations of minors with Pediatric Multisystem Inflammatory Syndrome (SIM-P) in late January they reached 100 a week. At the last pandemic peak in the country, that number was 40. In Brazil, the most recent data from the Ministry of Health October 2020, but a survey carried out by Young pan directly with the health departments of the Brazilian states shows that the updated number is higher: more than 660 cases of SIM-P have been counted since April last year. Despite this, experts guarantee that there is no reason to panic, since the occurrence of the disease is rare and there is a treatment protocol in Brazil.
What are the symptoms of the disease and how long do they appear?
When it was first reported in April 2020 in the UK, Pediatric Multisystem Inflammatory Syndrome (SIM-P) was confused with another rare disease because of the symptoms it had. “The initial general symptoms of fever, diarrhea and skin manifestations were associated with Kawasaki’s disease”, recalls InCor’s cardio pediatrician, Estela Azeka. The presence of other manifestations, however, made doctors rule out the possibility and investigate the connection between SIM-P and Covid-19. “The entire pathophysiology of the disease is not fully understood. There is, in fact, an inflammatory syndrome, as if it were a ‘storm of release of inflammatory markers’, an immunological activation ”, explains the doctor. In more severe cases, patients also had changes in the heart, lung and even conjunctivitis.
Doctors remember, however, that the symptoms do not manifest with the contamination by Covid-19. “She has been seen for a few weeks after the infection occurred [pelo coronavírus], usually two to four weeks later ”, points out Dr. Marco Aurélio Sáfadi, president of the Immunizations Department of the São Paulo Pediatric Society (SPSP). The expert says that the reasons why the syndrome is mostly registered in children has not yet been discovered, but points out that it appears to be triggered by an unbalanced antibody response. “It is related to the type of immune response that children have. It is a rare syndrome, so we see rare cases in the country ”, explains Sáfadi. In addition, according to him, there are few cases of SIM-P registered in adults around the world.
What is the treatment? Can the syndrome lead to death?
Depending on the severity, part of the SIM-P cases are treated in Intensive Care Units (ICUs) of hospitals following a protocol established by the pediatric society. “There is a basic protocol within the Intensive Care Units, where they use drugs that are not directed at the virus, but at the inflammatory response that occurs”, says the SPSP specialist. The disease is classified as “potentially serious”, but has a small chance of death. Doctors stress that parents should not despair, since very few cases of the disease are registered in the country. “Multisystemic inflammatory syndrome in children is not common. People should not panic because of this situation. This has to be very clear ”, says Azeka. According to data from the Ministry of Health, until October 2020, when the latest figures on the disease in the country were released, 35 deaths were recorded. In some states that have had a record of the disease, such as Maranhão and Minas Gerais, no deaths have been recorded so far.
How many cases have already been registered in Brazil?
In August, the Brazilian Society of Pediatrics (SBP) ordered that all cases of the disease registered in the country be immediately reported to the Ministry of Health. However, the most recent public data on the syndrome folder are from epidemiological bulletin number 45, which computes notifications made until October 24 and shows 511 infections of the type in the country, with 35 deaths. A survey by Young pan directly with the health departments of the Brazilian states shows that the updated number is higher. Of the 27 federative units sought by the report, 19 released updated figures and three had recent newsletters about the disease, totaling 661 confirmations and at least 31 deaths. The states with the highest number of registrations are São Paulo, Ceará and Minas Gerais. Check below how many occurrences of the syndrome each of them has had since the beginning of the pandemic: