Tomisaku Kawasaki is a Japanese pediatrician and is 95 years old. At 42, he described for the first time an inflammatory pathology never seen before in scientific reading, an acute inflammation of the small and medium caliber vessels that mainly affects children. Now hundreds of cases around the world and the possible correlation between this type of inflammation and Coronavirus have brought great attention to a disease so far almost unknown, at least outside the circle of specialists.
For this reason, on the Italian night between Saturday 23 and Sunday 24 May, hundreds of pediatricians met on Zoom to discuss it, invited by the Boston Children’s Hospital. And this is already the second conference. The first, always organized by the US hospital, had been called on the evening of May 2.
The pediatrician Angelo Ravelli: «Now we can say that this disease is temporally linked to the Coronavirus»
One of the Italian experts who will participate in the meeting is Angelo Ravelli, pediatrician and director of the Rheumatology Clinic of the Gaslini Hospital in Genoa. He will present the data from Italy, one of the territories in which there have been more cases of Kawasaki disease.
Before saying that there is a clear causality between Coronavirus and Kawasaki disease, data and analyzes are still needed, but the idea that the experts are working on now is precisely this. “There are strong suspicions that Coronavirus has something to do with these diseases and that is that this virus has triggered them, at least in a number of cases.”
Currently it is only possible to argue that there is a temporal link between this syndrome and Coronavirus: while the pandemic was affecting the world, the cases were recorded simultaneously in Italy and other European countries, and in the United States, especially on the North East coast. And, as explains Ravelli, where the Covid-19 epidemic is in retreat there are also fewer cases of Kawasaki disease.
New York state cases
“The more we look, the more we find it”. “The more we look for it, the more we find it.” New York State Governor Andrew Cuomo thus introduced the press conference on the existence of the research that is underway on 157 cases of diseases similar to Kawasaki disease already found in the state. Cases that have increased by 53% in the past 9 days.
In the United States, attention to this syndrome is becoming very high, especially after it appears to be linked to the death of three patients, aged 5, 7 and 18 respectively. Although doctors have specified that it is not yet safe whether it is Kawasaki disease. At the moment the symptoms are very similar but this pathology may not be classified in the same way.
Journalists Joseph Goldstein and Jesse McKinley published a report on the New York Times in which they tell how a team of over 30 experts from various medical disciplines is analyzing all these cases to try to understand exactly what the disease is.
The work is frenetic, as explained by Dr. Howard A. Zucker, one of the doctors involved in this research: «We are examining everything possible – therapies, diagnosis, clinical picture – and we are trying to put everything together. There is one thing that keeps you awake at night. It is the concern that maybe in six months we will notice something that will make us say “How come we didn’t think about that therapy?”.
The study of hospital pediatricians
Pope John XXIII of Bergamo
What is happening in the United States is not far from what Italian pediatricians have already seen in Bergamo. In this area, one of the most affected by Coronavirus in Italy, there have been ten cases of suspected 61-day Kawasaki disease. Few, ever. Yet, if you look at the historian, you can see that in the last five years the average of the cases recorded for this pathology in the same territory is four per year. Considering that 2020 is not even halfway, these ten cases recorded between 18 February and 20 April certainly represent a surge.
This curve was analyzed by a group of pediatricians from the Papa Giovanni XXIII hospital in Bergamo who in recent days has published a study in the scientific journal Lancet. Also from this paperexactly as in the US research, we read that the pathology analyzed is similar to Kawasaki disease but it is not said that it is the same. Compared to the disease described by the Japanese pediatrician Tomisaku, that found in children living in territories very affected by the Coronavirus would have more serious symptoms and above all major complications at the heart level.
Eight of the ten patients analyzed in this study also tested positive for Coronavirus. However, the authors speculate that the other two are false negatives, patients in whom the Covid-19 test did not work. In a few hours the cases of Bergamo and those of New York will be analyzed around the same table organized by the Boston Children’s Hospital, to understand if this Coronavirus epidemic still hides sides that we do not know.
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