Studies Detail Syndrome in Kids Linked to COVID
|Nearly 300 children in 26 states fell ill with a mysterious COVID-related inflammatory condition between March and May, a pair of new studies show. Six of the children died.|
The studies are the most detailed accounts to date of the illness called multisystem inflammatory syndrome in children, or MIS-C. And they’re giving pediatricians and parents a better idea what the condition looks like when it strikes.
MIS-C is different than the severe course of COVID-19 that can imperil medically fragile children. MIS-C is a condition that seems to hit previously healthy kids days to weeks after they’ve fought off the virus that causes COVID-19.
The most common symptoms of MIS-C were fevers lasting an average of 5 days. More than 90% also had some kind of gastrointestinal complaint -- nausea, vomiting, diarrhea, and belly pain. Many kids also had heart problems in response to the syndrome, including coronary artery aneurysms, where a weak spot in the arteries that feed the heart balloons dangerously. The majority also had markers of body-wide inflammation, such as high levels of C-reactive protein in their blood.
More than two-thirds of the children in the study had some evidence that they’d come into contact with COVID-19, either because a blood test for the virus was positive or because they had been around a person who was known to be diagnosed with it.
The studies, which are published in The New England Journal of Medicine, are a snapshot of cases rather than an exact count.
“This is a minimum number. We didn’t collect cases from every ICU in America,” says Adrienne Randolph, MD, a critical care specialist at Boston Children’s Hospital. She says 53 intensive care units contributed data to the study.
Nearly 100 of the cases detailed in the studies came from New York state, which has been the epicenter of the coronavirus pandemic in the U.S.
In the second study, researchers from the New York State Department of Health analyzed their cases. They conclude that MIS-C is clearly linked to COVID-19, with the peak of cases of MIS-C trailing the peak of COVID-19 cases seen in New York by 1 month.
They note that about a third of the children affected in New York had a preexisting condition, most commonly obesity.
The syndrome shares features of Kawasaki disease, a rare syndrome that strikes children after they’ve fought off an infection. Kawasaki disease can also affect the heart, and it often causes kids to get skin rashes; a swollen, red “strawberry tongue;” red, cracked lips; peeling skin on their hands or feet; and red eyes. The main risk of Kawasaki disease is inflammation of the blood vessels, particularly the ones that deliver blood to the heart.
In the New York study, researchers found that the features of MIS-C that most closely resemble Kawasaki disease were more common in younger children.
“It’s important to touch base with a pediatrician, especially this time of year, because there isn’t much going around right now,” Randolph says
With MIS-C and Kawasaki disease, early treatment is key. Prolonged inflammation can lead to permanent heart damage, if it isn’t caught and stopped.