COVID-19 cases among young children continue to increase in HK, croup symptoms reported daily

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Dr. Mike Kwan Yat-wah

17th August 2022 – (Hong Kong) Many severe COVID-19 cases involving young children have been recorded in Hong Kong recently, and some of them developed serious complications, such as acute necrotising encephalitis and croup. Dr. Mike Kwan Yat-wah, Consultant Paediatric Infectious Diseases, Princess Margaret Hospital said that in recent days, the hospital has received new cases of croup almost every other day. The paediatric patients admitted to the intensive care unit are only the “tip of the iceberg”, hence, parents should not take it lightly. He emphasised that children are at great risk after being infected with the COVID-19 virus, and there is a chance of intermediate sequelae (multi-system inflammatory syndrome in children) or “long-term Covid” among young children after recovery. Princess Margaret Hospital has followed up on 288 cases of recovered sick children, of which more than 30% of children have at least one or more “long-term Covid” symptoms, such as memory loss, headache, rashes, temporary loss of vision and hair loss. The situation is worrying.

Dr.Kwan said that the Faculty of Medicine of the University of Hong Kong has analysed the fifth wave of sick children aged 11 or below who were admitted to the hospital and found that about 15% of them had neurological complications, more than 5% had respiratory complications, and more 1.8% required hospitalisation in the paediatric intensive care unit. Among them, croup and acute necrotising encephalitis were the most common complications. He pointed out that croup s a kind of swelling of the throat, trachea and bronchi caused by viral infection, which hinders breathing, making it difficult to breathe. Acute necrotising encephalitis is more of a devastating neurological disease, and children often experience severe symptoms such as convulsions for more than 30 minutes, loss of consciousness, and difficulty in breathing.

If parents notice any serious symptoms in their sick child, such as cramps, difficulty breathing, blue lips, etc., they should seek medical attention immediately. In terms of sequelae, multi-system inflammatory syndrome in children (MIS-C) mostly occurs within 2 to 8 weeks, and most of the symptoms are persistent fever, tracheal inflammation, etc. So far, there have been more than 50 cases of sick children with this sequelae, and more than half of them have the disease. Dr. Kwan also said that Princess Margaret Hospital has followed up on 288 cases of recovered sick children, the youngest is 8 years old and the oldest is 13 years old, and more than 30% of the children have at least one or more long Covid symptoms, such as memory loss, headache, rashes, temporary loss of vision and hair loss.


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