SEVERE WX : Air Stagnation Advisory View Alerts

Kids with suspected Covid-related syndrome need immediate attention, doctors say

Kids who may have multisystem inflammatory syndrome in children, or MIS-C, a troubling complication of Covid-19 infection, need immediate attention and will...

Posted: May 20, 2020 3:00 AM

Kids who may have multisystem inflammatory syndrome in children, or MIS-C, a troubling complication of Covid-19 infection, need immediate attention and will probably need to be hospitalized, doctors said Tuesday.

Symptoms do not look like the classic symptoms of coronavirus and may mostly include stomach pain and vomiting, along with fever and perhaps a rash, the experts told other doctors during a meeting Tuesday organized by the US Centers for Disease Control and Prevention.

It's becoming clear that many of the children with the new syndrome have damage to their hearts and need immediate treatment, they said at the Clinician Outreach and Communication Activity (COCA) briefing. And they believe it's increasingly clear that Covid-19 is involved, even though many of the children test negative for the virus at first and never seemed to have had symptoms of infection.

The syndrome appears to develop two to six weeks after infection with Covid-19 and affects mostly children who were perfectly healthy beforehand. The CDC issued a health alert last week warning pediatricians to be on the lookout, and at least 20 states plus Washington, DC have reported they are investigating possible cases.

"A striking finding here -- alarming -- is that in this group, about half the children already had coronary artery abnormalities," Dr. James Schneider, who heads pediatric critical care at Northwell Health in New York, told the briefing. Because the children were previously healthy, he thinks the abnormalities were caused by MIS-C, possibly as a result of a delayed immune response to the coronavirus.

"Any child at home who has fever, abdominal pain or symptoms such as rash and conjunctivitis should be seen by a pediatrician right away," he advised. "I think we need to have a low threshold for evaluation."

'Alarming' findings

More than half of the 33 children treated for MIS-C at Northwell in April and May had developed some sort of heart dysfunction, Schneider said. "They need good, old-fashioned critical care."

And most of the children had no underlying conditions that might make parents wary. "No definitive underlying conditions predispose children to this," he said.

Infectious disease specialist Dr. Nicholas Rister at Cook Children's Medical Center in Fort Worth, Texas, said he has examined several children with a range of symptoms.

"I feel very terrible -- some patients have said, you know, everything kind of hurts. And then swelling in various points of your body, especially your hands and your feet, and even your mouth," he said at a separate briefing.

"The biggest concern we have right now, especially in kids, is largely stemming from inflammation around the heart," he said. It's one reason doctors at first thought the syndrome was a rare condition known as Kawasaki disease. "And not just the heart but the major vessels around the heart," he added.

Dr. Michael Levin of Imperial College in London, who treated some of the first patients in Britain, said parents may hesitate to bring their children in, but they should.

Some of the children he and his colleagues have treated were already critically ill when they arrived at the hospital. "One of the reasons for this may have been the lockdown and fear of coming to hospital," he said. "The public health message in the UK was that patients should try and stay at home and not attend hospital," he added. So children were staying home with fevers ... and arriving in a seriously ill state."

Blood tests will quickly tell doctors if children might be experiencing MIS-C, Levin said. Tests for inflammation and heart damage can show if children are at risk and need to be hospitalized.

Quick treatment appears to work and most children go home after a few days in the hospital, both Schneider and Levin said.

Levin said most children tested negative for Covid-19 infection at first but later tests indicated they had probably had a past infection.

He said these young patients were showing symptoms of extreme inflammatory response. "There is a concern that we are seeing a dysregulated immune response," Levin told the briefing. "The timing of this illness does seem to coincide with when acquired immunity would be developing."

Many of the children in England who were diagnosed with MIS-C are from ethnic minoritie, Levin said. "There seemed to be a predominance of children from black, African, Caribbean-British ancestry who accounted for about 46% of the cases," he said.

Twenty-seven percent of the children with the illness in a recent New York study were Hispanic, Northwell's Schneider said.

Oregon Coronavirus Cases

Data is updated nightly.

Cases: 70832

Reported Deaths: 885
CountyCasesDeaths
Multnomah15875232
Washington997499
Marion9017137
Clackamas585377
Umatilla430149
Lane420241
Jackson364428
Malheur237942
Deschutes222814
Yamhill164816
Linn138522
Polk116816
Douglas91217
Jefferson80811
Union7715
Benton7667
Klamath7604
Morrow6517
Lincoln61315
Wasco51919
Josephine5104
Columbia4783
Coos4182
Hood River3941
Clatsop3510
Baker2723
Crook2176
Grant1341
Curry1292
Tillamook1230
Lake1171
Harney961
Wallowa713
Sherman230
Gilliam220
Wheeler30
Unassigned00

California Coronavirus Cases

Data is updated nightly.

Cases: 1185576

Reported Deaths: 19089
CountyCasesDeaths
Los Angeles3877937604
San Bernardino902221129
Riverside857741437
San Diego76359996
Orange750951577
Kern40337448
Fresno37724481
Sacramento35854566
Santa Clara32985476
Alameda28857505
San Joaquin25738502
Contra Costa23571261
Stanislaus21460424
Tulare20649308
Ventura19058175
Imperial15862356
San Francisco15156160
Monterey14750116
San Mateo13715170
Sonoma11922157
Merced11537179
Santa Barbara11277135
Kings1047587
Solano1003681
Marin7628129
Placer635468
Madera604785
San Luis Obispo596435
Shasta471847
Yolo462675
Santa Cruz426928
Butte389459
Sutter314415
Napa298817
El Dorado22174
Yuba198110
San Benito183716
Lassen17733
Tehama161225
Mendocino148522
Nevada11849
Tuolumne9088
Glenn8928
Lake89019
Humboldt8509
Colusa6946
Siskiyou6242
Mono5273
Amador52016
Calaveras47822
Del Norte3131
Inyo29016
Plumas2050
Trinity1390
Mariposa1282
Modoc1250
Alpine470
Sierra190
Unassigned00
Medford
Overcast
32° wxIcon
Hi: 50° Lo: 30°
Feels Like: 32°
Brookings
Clear
36° wxIcon
Hi: 56° Lo: 40°
Feels Like: 36°
Crater Lake
Clear
17° wxIcon
Hi: 42° Lo: 22°
Feels Like: 17°
Grants Pass
Overcast
34° wxIcon
Hi: 50° Lo: 30°
Feels Like: 30°
Klamath Falls
Clear
17° wxIcon
Hi: 43° Lo: 19°
Feels Like: 17°
Dense, freezing fog tonight
KDRV Radar
KDRV Fire Danger
KDRV Weather Cam

Community Events