Case Reports in Pediatrics describes an 8yr old girl in Oklahoma, USA, who developed pretty typical Sydenham’s chorea with high streptococcal tests (ASO and anti DNAse B). She had heart involvement too, so comes into the category of rheumatic fever.

So far, so good. Where it gets interesting, is the fact her parents had been diagnosed with COVID-19 2 weeks before, and she tested positive too, although she didn’t have any signs. And she didn’t have any history of a recent sore throat, fever or skin infection.

Just bad luck? Maybe, but the authors comment that having a virus can increase your risk of then getting a bacterial infection, and there’s every reason to think coronavirus could do the same. The fact she still has chronic fatigue and persistent chorea a few months later they suggest might have something to do with coronavirus. I’m not sure there’s really any way of knowing, nor does it change how you deal with it.

They did a range of tests including CT brain, MRI brain, MR angiography – they seem to have only done all these tests because she tested positive for coronavirus.