Covid-19 after-effect? Bengaluru hospitals treat children with pale feet

Doctors suspect blockage of smaller blood vessels during post-Covid recovery

Two city hospitals have found children with pale toes, which they determined as a post-Covid reaction.

While Koramangala-based Growing Up Children's Clinic reported five such cases, Apollo Hospital, Bannerghatta Road, has seen three.

While Apollo found the cases to be self-limiting and resolving on their own without medical or surgical intervention, the clinic gave children mild steroid hydrocortisone for the redness and swelling.

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Doctors urge parents to look for the symptoms, while also advising physicians to check the toes besides focusing on the chest and respiratory system when they come for post-Covid follow-up.

Dr Sreenath S Manikanti, senior paediatrician and neonatologist at Growing Up Children's Clinic, said the body will start an inflammatory response against the virus after the active Covid infection is resolved. “This affects small blood vessels in the toes and hands,” he said. “We have seen five post-Covid inflammatory cases.”

Dr Manikanti prescribed analgesics like paracetamol and ibuprofen. He said the cases were seen mostly in children aged between five and 11, pointing out that such inflammation is seen in cold countries.

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“India is a warm country and so we suspect it to be secondary to Covid,” he said. "There is no proven association, but since the child has a history of Covid and the dermatology association also feels so, we think it is because of Covid," he said.

Most did not have pain due to the condition, whose symptoms range from itching and redness to swelling.

"In case the child has pain, analgesics can be used. Hydrocortisone takes one week to act, so usually a two-week course is prescribed. The majority of them only get discolouration. Only two complained of pain," he said.

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Dr Prashanth S Urs, HOD of Neonatology at Apollo Bannerghatta Road, said the three children with symptoms seen at the hospital were aged between two and three. “They were coming (for follow-ups) three to six months after recovery (from Covid),” he said. The children came with cold feet and hands.

Although no pain was reported, the feet and hands were paler than the rest of the body, indicating limited blood circulation. “We did a doppler to rule out any blood vessel blockage. The condition resolved by itself in two weeks without any medical treatment," he said.

“Covid mainly causes blood clots so maybe this has a similar pathology, but it could be a micro-vascular problem, which cannot be detected on a doppler,” he said.

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