Most children who receive expert multidisciplinary care survive. In addition to respiratory distress, major complications that may need aggressive supportive care can include myocardial damage, acute kidney injury, and coagulopathy (thrombophilia). In some cases, sustained cardiac arrhythmias have led to haemodynamic collapse and need for extracorporeal membrane oxygenation (ECMO). Deaths have been recorded in a small minority (under 2%) of the cases reported. Occasionally, fatalities  have followed complications of ECMO. Some children exposed to COVID-19 also appear to have a less severe Kawasaki-like disease. Ventricular function often recovers before discharge from hospital (often after 6–10 days). Coronary artery aneurysms can develop even in the absence of Kawasaki-like features. Their frequency and severity is uncertain. So far, they have been recorded in 7% of reported cases. Long-term prognosis is unclear. Diagnosis
Diagnosis is by specialist clinical evaluation. Diagnostic suspicion may be raised by unexplained persistent fever and clinically concerning symptoms following exposure to COVID-19. Families need to seek immediate medical care, as the childs condition can deteriorate rapidly. Paediatricians first involvement is often in the emergency department. Early recognition and multidisciplinary referral to paediatric specialists (in intensive care, infectious diseases, cardiology, haematology, rheumatology, etc.) is essential. Examinations may include blood tests, chest x-ray, heart ultrasound (echocardiography), and abdominal ultrasound. Clinicians worldwide have been urged to consider this condition in children who display some or all the features of Kawasaki disease or toxic shock syndrome. Case definitions and guidance
A universally accepted case definition for this newly described syndrome has still not been agreed.
The United Nations recognizes that poverty and malnutrition (as well as the environment) are interdependent and complementary with population growth. According to the World Health Organisation, "Family planning is key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment, and national and regional development efforts". However, more than 200 million women worldwide lack adequate access to family planning services. There are different theories about what causes famine. Some theorists, like the Indian economist Amartya Sen, believe that the world has more than enough resources to sustain its population. In this view, malnutrition is caused by unequal distribution of resources and under- or unutilized arable land. For example, Sen argues that "no matter how a famine is caused, methods of breaking it call for a large supply of food in the public distribution system. This applies not only to organizing rationing and control, but also to undertaking work programmes and other methods of increasing purchasing power for those hit by shifts in exchange entitlements in a general inflationary situation." Food sovereignty
Food sovereignty is one suggested policy framework to resolve access issues. In this framework, people (rather than international market forces) have the right to define their own food, agricultural, livestock, and fishery systems. Food First is one of the primary think tanks working to build support for food sovereignty. Neoliberals advocate for an increasing role of the free market. Health facilities
Another possible long-term solution to malnutrition is to increase access to health facilities in rural parts of the world.