No known cases of COVID-linked syndrome among children in Singapore: health experts

SINGAPORE — There have been no known cases so far of children affected by a new life-threatening inflammatory syndrome associated with COVID-19 in Singapore, said healthcare experts here.

Earlier this month, European and American health authorities reported that hundreds of children have been afflicted with the mystery condition, known as paediatric inflammatory multisystem syndrome (PIMS), with at least five – three in New York, and one each in France and the UK – succumbing to it.

The syndrome can cause multiple organ failure and shares symptoms with toxic shock and Kawasaki disease, a rare inflammation of the blood vessels that typically affects young children under the age of five.

Among the symptoms are fever, swollen glands, rashes, acute gastrointestinal problems, and even heart inflammation.

“While we have not seen COVID-19 related cases of Kawasaki disease, we will continue to monitor the trend and cases of patients admitted to the hospital with Kawasaki disease,” said Associate Professor Thoon Koh Cheng, head and senior consultant at the department of paediatrics’ infectious disease service at KK Women’s and Children’s Hospital (KKH).

Similarly, the National Centre for Infectious Diseases (NCID) “has not observed signs of toxic shock and Kawasaki disease among (its) paediatric population”, said the centre’s clinical director Dr Shawn Vasoo. The centre is actively monitoring for any signs of such cases, he added.

The World Health Organization (WHO) has issued a preliminary definition of the syndrome, which it said had become more frequent during the pandemic but has also appeared in children who did not test positive for COVID-19.

The case definition pertained to children who had contracted COVID-19 or had had likely contact with COVID-19 patients, and had no other obvious microbial cause of inflammation, it said.

At a briefing in Geneva last week, the organisation also urged clinicians to be alert to the syndrome and gather more data on it.

“I call on all clinicians worldwide to work with your national authorities and the WHO to be on the alert and better understand this syndrome in children,” WHO director-general Tedros Adhanom Ghebreyesus said.

The Ministry of Health (MOH) likewise advised doctors in Singapore on Monday to refer cases who exhibit Kawasaki-like symptoms to the Children's Emergency at KKH and National University Hospital (NUH) as well as remain “watchful” for them in paediatric cases infected with COVID-19.

In general, children infected by COVID-19 have displayed milder symptoms compared with adults and are not thought to be major transmitters of the disease.

As of Wednesday, 60 children – aged 16 and below – have been confirmed to be infected by COVID-19 in Singapore, said the MOH. Of them, 57 have fully recovered from the infection and have been discharged from hospital, and three are recovering in the hospital.

None have been in the intensive care unit, the ministry added.

While the majority of COVID-19 cases aged 16 and below are typically hospitalised at paediatric hospitals here – namely KKH and NUH – the NCID occasionally admits infected children to allow them to remain with family members who are also COVID-19 cases and if they are in stable condition, Dr Vasoo said.

In a peer-reviewed study by The Lancet published in May, the prominent medical journal observed that the syndrome remains rare, "affecting no more than one in 1,000 children exposed to SARS-CoV-2" – the virus that causes COVID-19.

During last week’s briefing, the WHO also cautioned that the syndrome’s links to COVID-19 are still unclear.

“We know, so far, very little about this inflammatory syndrome,” said WHO epidemiologist Maria Van Kerkhove.

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