May 15, 2020

COVID-19: Global death toll exceeds 300,000; ECDC publishes risk assessment on paediatric inflammatory multisystem syndrome

According to the European Centre for Disease Prevention and Control (ECDC), since 31 December 2019 and as of 15 May 2020, 4 405 680 cases of COVID-19 have been reported, including 302 115 deaths.

Cases have been reported from:

Africa: 75 685 cases; the five countries reporting most cases are South Africa (12 739), Egypt (10 829), Morocco (6 607), Algeria (6 442) and Ghana (5 530).

Asia: 732 064 cases; the five countries reporting most cases are Turkey (144 749), Iran (114 533), China (84 029), India (81 970) and Saudi Arabia (46 869).

America: 1 943 455 cases; the five countries reporting most cases are United States (1 417 889), Brazil (202 918), Peru (80 604), Canada (73 401) and Mexico (42 595).

Europe: 1 645 366 cases; the five countries reporting most cases are Russia (252 245), United Kingdom (233 151), Spain (229 540), Italy (223 096) and Germany (173 152).

Oceania: 8 414 cases; the five countries reporting most cases are Australia (6 989), New Zealand (1 148), Guam (154), French Polynesia (60) and Northern Mariana Islands (19).

Other: 696 cases have been reported from an international conveyance in Japan.

Deaths have been reported from:

Africa: 2 563 deaths; the five countries reporting most deaths are Egypt (571), Algeria (529), South Africa (238), Morocco (190) and Nigeria (167).

Asia: 23 531 deaths; the five countries reporting most deaths are Iran (6 854), China (4 637), Turkey (4 007), India (2 649) and Indonesia (1 043).

America: 117 069 deaths; the five countries reporting most deaths are United States (85 906), Brazil (13 993), Canada (5 472), Mexico (4 477) and Ecuador (2 338).

Europe: 158 819 deaths; the five countries reporting most deaths are United Kingdom (33 614), Italy (31 368), France (27 425), Spain (27 321) and Belgium (8 903).

Oceania: 126 deaths; the four countries reporting deaths are Australia (98), New Zealand (21), Guam (5) and Northern Mariana Islands (2).

Other: 7 deaths have been reported from an international conveyance in Japan.

[Note by ECDC: The data presented have been collected between 6:00 and 10:00 CET , 15 May.]

Rapid risk assessment: Paediatric inflammatory multisystem syndrome and SARS -CoV-2 infection in children

The ECDC has published a Rapid Risk Assessment on paediatric inflammatory multisystem syndrome and SARS -CoV-2 infection in children.

According to ECDC, several countries affected by the COVID-19 pandemic recently reported cases of children that were hospitalised in intensive care due to a rare paediatric inflammatory multisystem syndrome (PIMS). The presenting signs and symptoms are a mix of the ones for Kawasaki disease (KD) and toxic shock syndrome (TSS) and are characterised, among others, by fever, abdominal pain and cardiac involvement. A possible temporal association with SARS-COV-2 infection has been hypothesised because some of the children that were tested for SARS-CoV-2 infection were either positive by polymerase chain reaction (PCR) or serology.

The ECDC noted that about 230 suspected cases of this new paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) have been reported in EU/EEA countries and the UK in 2020, including two fatalities- one in the UK and one in France. These cases are being further investigated.

"So far, epidemiological studies have shown that children appear to be less affected by COVID-19. Only 2.1% of all laboratory-confirmed COVID-19 cases reported to The European Surveillance System (TESSy) were in the age group between 0 and 14 years of age", the agency stated.

The ECDC also added that an association between SARS-CoV-2 infection and this new clinical entity of multisystem inflammation has not yet been established to date, although an association appears plausible.The ECDC assessed the risks as follows:

  • The overall risk of COVID-19 in children in the EU/EEA and UK is currently considered low, based on a low probability of COVID-19 in children and a moderate impact of such disease.
  • The overall risk of PIMS-TS in children in the EU/EEA and the UK – is considered low, based on a very low probability of PIMS-TS in children and a high impact of such disease.

"While the clinical management of these children has absolute priority, data collection from EU/EEA Member States and the UK would strengthen the body of knowledge for this rare condition and allow for a better analysis of these cases. An analysis of surveillance data could clarify the incidence of KD/PIMS and identify the most affected age groups and risk factors for both conditions", the ECDC noted.

ECDC has agreed with the EU/EAA Member States and the UK to include PIMS as a possible complication to be reported for EU-level COVID-19 surveillance. According to the agency, research efforts should aim at determining the role of SARS-CoV-2 in the pathogenesis of PIMS-TS and answering other significant remaining questions.

SOURCE: ECDC