Potential link between coronavirus and inflammatory syndrome in children
Reaction and analysis from Dr. Roberta Debiasi, Division Chief of Pediatric Infectious Diseases at Children's National Hospital, on ‘America’s News HQ.’
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At least two children in Washington, D.C., have been affected by a rare inflammatory condition that doctors think is linked to the novel coronavirus.
Two pediatric patients at Children’s National who tested positive for the novel coronavirus have also developed a Kawasaki disease-like inflammatory condition, The Washington Post reported. Kawasaki disease causes swelling in medium-sized arteries throughout the body, causing a high, persistent fever, swollen lips and tongue, a rash, and swollen hands and feet, among other signs.
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Though doctors have treated Kawasaki disease, which primarily affects young children, for several decades, “What’s uncommon now is with these patients coming in after being exposed to [the coronavirus], we’re seeing a much more severe form of it where people actually have Kawasaki disease as well as additional symptoms like shock,” Michael Bell, the chief of critical care medicine at Children’s National, told The Post.
“The first kid that came in here was at the exact right age — around 5 years of age,” Bell added. “He had classic symptoms of a rash, [swollen] lymph nodes, cracked lips, swollen tongue. And if COVID was not involved at all, we would have just said he had Kawasaki and that was it. But he tested positive for COVID on his first day here.”
Bell said the 5-year-old's heart was in failure when he arrived at the hospital and required “a lot of therapy to get over that.”
“He’s doing quite well now but it took three or four days of intensive work to get him into the right state,” he continued.
The second case of the inflammatory condition was reported in a 9-year-old patient, the outlet reported. That child “also had the heart abnormalities and his coronary arteries were also dilated, so we’re concerned about him,” said Bell, though he noted the 9-year-old had less severe symptoms overall than the 5-year-old.
More cases of the Kawasaki disease-like inflammatory condition are likely to pop up in other children around the country as the virus continues to spread, Bell noted, echoing officials from Yale-New Haven Children’s Hospital (YNHCH) in Connecticut, which on Monday announced three cases of the condition in pediatric coronavirus patients there.
The cases are said to be the state’s first of pediatric inflammatory multisystem syndrome, or PIMS, the Kawasaki disease-like condition. The cases have since been reported to the Connecticut Department of Public health, the hospital said in a news release.
“Unfortunately, this disease carries features of toxic shock syndrome and elements of Kawasaki disease and strikes school-aged children. While these cases are exceptionally rare, given our proximity to New York where there has been a significant number reported, we have been watching their experience closely,” said Clifford Bogue, physician-in-chief of YNHCH, in a statement.
The news comes after British health authorities, in a warning to health care professionals in late April, said that some severely ill pediatric patients in the country — including some who were positive for the coronavirus — presented an “unusual clinical picture” that included inflammatory symptoms possibly linked to COVID-19.
The U.K. Pediatric Intensive Care Society (PICS), citing an email alert from the National Health Service (NHS) in England, said in a news release that health officials had reported “a small rise in the number of cases of critically ill children presenting with an unusual clinical picture” at the time. More specifically, it is a “multi-system inflammatory state” that may be connected to the novel virus.
“The cases have in common overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe COVID-19 in children. Abdominal pain and gastrointestinal symptoms have been a common feature as has cardiac inflammation,” the NHS notice reads, per PICS.
Since then, at least three young children in New York have died after being hospitalized with the rare Kawasaki disease-like illness, New York Gov. Andrew Cuomo said Saturday.
The condition has also affected several patients at Children’s Hospital Los Angeles in California, as well as at least one child in Louisiana.
A 6-month-old who was hospitalized in California with Kawasaki disease last month also tested positive for COVID-19, Reuters reported at the time.
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Dr. Jacqueline Szmuszkovicz, a pediatric cardiologist at Children’s Hospital Los Angeles, recently said that children who have a fever that lasts for four or more days should seek medical attention.
“Certainly, if they see any of the other signs — the rash, the red tongue, red eyes — we encourage them to seek care,” she told The Los Angeles Times.
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