The twenty children hospitalized in recent days in the Parisian resuscitation services for heart failure have “All been in contact” with the Sars-CoV-2 virus. The link was confirmed on Thursday by the Necker Hospital team at a press conference of the Assistance Publique-Hôpitaux de Paris (AH-HP). Since April 15, an unexpected number of children with myocarditis (inflammation of the heart muscle) have been admitted to the pediatric departments of Ile-de-France. The majority of them have a close but incomplete clinical picture of Kawasaki disease, an inflammation of the vessels often secondary to a viral infection.
After two weeks of alert in France, but also in the United Kingdom, in Spain or in Italy which noted the same phenomenon, the first big questioning on the possible connection with the Covid-19 has just been raised for the cases French. “These children have all been in contact at one time or another with this virus”, confirmed Sylvain Renolleau, head of the resuscitation and continuous medical and surgical surveillance department of Necker. By testing them, the pediatricians realized that all of these young patients had either a PCR “still positive but weak”(Diagnosis which makes it possible to see if the person is infected at an instant T), or a positive serological test (which establishes after the fact that the virus has indeed been present in the body).
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A significant number of these tests made it possible to establish contact with the virus dating from three to four weeks. “What we understand about the timing of the arrival of these children, in a different way from the start of the epidemic in adults, is that it is probably a post-infectious disease, of immunology mechanisms that follow Covid 19 infection“Said Damien Bonnet, head of Pediatric Medical Cardiology at Necker. Even if today we do not have all the arguments of certainty to say that there is a direct causal link.“
“Complete restoration of cardiac function”
According to the information communicated by the medical staff, all these children needed ventilatory help because of this “Exaggerated inflammatory reaction”. A reaction which would therefore lead to cardiac and not pulmonary damage as in adults with Covid. “They almost all needed medication support to help heart function and normalize blood pressure, said Sylvain Renolleau. To date, they have all progressed favorably in three to four days of intensive care, with a complete return of cardiac function for the time being, even if the monitoring period is currently short. “
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In a note dated April 29 and distributed to the group’s doctors, the AP-HP crisis medical director, Bruno Riou, indicates that 21 cases in fact are currently being taken care of in pediatric resuscitation. A 16-year-old girl is also in intensive care at the Pitié-Salpêtrière. The document also reports other cases in the following cities: “Reims, Nancy, Bordeaux, Montpellier, Chambéry and Lyon.“