More than 150 children in 19 states and Washington, D.C. have now been affected by a serious new inflammatory condition with possible connections to COVID-19. The Centers for Disease Control and Prevention (CDC) released a health alert on May 14 to help track what’s now known as multisystem inflammatory syndrome in children (MIS-C), and parents are keeping a watchful eye as many states continue taking steps to reopen.
Although a number of the MIS-C symptoms resemble Kawasaki disease, a rare condition that causes inflammation of blood vessels seen mostly in the younger populations, this particular collection of symptoms is different than anything that’s been previously seen, says Dr. Reginald Washington, chief medical officer of the Rocky Mountain Hospital for Children.
“All I can say is, we’re gathering information as a medical profession,” he says. “I think it’s premature to make any long-term conclusions based on the information we have.”
As for connections to COVID-19, some, but not all, patients with the new syndrome are reported to have had exposure to the novel coronavirus, according to antibody evidence. Dr. Washington is not ready to label it a complete cause and effect.
Reports say the syndrome is rare. Three cases of MIS-C have been reported in Colorado. But experts are asking families to keep a watchful eye for symptoms, which can turn serious if not addressed.
Along with redness in the eyes and skin, fever, dry lips, and gastrointestinal discomfort, a number of children have also developed vasculitis, or inflammation of the blood vessels. Dr. Washington notes that Kawasaki patients who’ve had similar inflammation develop serious coronary artery problems later on and require continued cardiology care. It’s too soon to say whether or not patients with this new syndrome will have the same issue, he says, but recommends careful monitoring in the long-term.
In terms of immediate treatment, “most of these kids have done quite well,” says Dr. Washington. “We treat the symptoms and they tend to recover. There’s no specific treatment for this [syndrome], and I don’t think there’ll probably be a specific treatment unless we can determine what the specific cause is.” There have been at least three reported deaths in New York, but it’s unclear whether those are due to COVID-19 infections or the inflammatory symptoms.
It is not yet known exactly how many children who have COVID-19 come down with these symptoms. Antibody tests for COVID-19 have not proven completely reliable, and medical professionals, says Dr. Washington, are still figuring out how to interpret them for adults and children. It’s unclear which test is best, at what point individuals should get tested, and how long a person’s antibodies could last.
Symptoms to watch for in your child:
- Sluggishness
- Fever
- Abdominal pain
- Vomiting
- Diarrhea
- Rash
- Redness in the whites of the eyes and patches on the skin
- Enlarged lymph node on one side of the neck
- Red, cracked lips or a tongue that looks like a strawberry
- Swollen hands and feet
If you notice any of these symptoms in your child, seek medical attention. Blood work will detect signs of infection and inflammation. A cardiac evaluation such as an ultrasound may also be ordered. “We know from some other parts of the country that some kids do have cardiac involvement,” says Dr. Washington. “Those patients probably should be followed on a regular basis by a pediatric cardiologist who can look at the situation to see if they’re developing any of these things.”
In the meantime, clean hand hygiene, wearing a mask, and social distancing are still the first lines of defense for families.
“Certainly as kids begin to interact, they go back to school or daycare or whatever the situation may be, we fully expect to see an increase in COVID cases,” says Dr. Washington. “How severe that will be, nobody knows just yet, but I think it’s too premature, in my opinion, to let our guard down and begin to think this has gone away, because it has not.”
Watch for developing details and read more about the CDC response to MIS-C on the CDC website.
