Mysterious coronavirus-related illness claims 3 children in New York, at least 73 sick
New York is helping CDC develop a national criteria for identifying and responding to a strange condition impacting kids, potentially related to Covid-19
While children were largely believed to have been spared in the coronavirus pandemic, doctors in the US are reporting a troubling new phenomenon: a strange inflammatory disease in children potentially related to Covid-19. The illness has now taken the lives of three young New Yorkers and over 70 have been impacted by it.
As of May 5, 64 “suspected pediatric clinical cases compatible with multi-system inflammatory syndrome associated with Covid-19” have been reported in children in New York State hospitals, including New York City, said the New York State Department of Health on May 6. The condition is being referred to as “Pediatric Multi-System Inflammatory Syndrome.”
However, on May 9, New York State Governor Andrew Cuomo said during a briefing that hospitals have reported 73 cases of what they now think maybe a Covid-19 related illness in children -- mostly toddler to elementary school age -- with symptoms similar to Kawasaki disease and toxic shock syndrome. Cuomo also said that three children have died in New York of inflammatory complications possibly linked to Covid-19. Kawasaki disease, which usually affects children 5 years and younger, is the presence of a high fever, rash on back, chest, and abdomen, swollen red hands and feet, and bloodshot eyes, among others.
The governor reported the first death of a five-year-old boy on May 8. At his briefing on May 9, Cuomo raised the number of fatalities to three, after the death of a seven-year-old and a teenager. “Tragically, three young New Yorkers have died of what may be a Covid-related illness in children. This illness has symptoms that are similar to Kawasaki disease & toxic shock syndrome. DOH is investigating & we will provide updates. Though rare, we urge parents to be vigilant,” he tweeted.
Cuomo said these children do not present symptoms that one normally associates with Covid-19, it is not a respiratory illness nor are they in respiratory distress. He explained that it is more of an inflammation of the blood vessels, which can then cause problems with their heart.
“This is new, and it’s developing. The Department of Health has communicated with the CDC. At the request of CDC, New York is helping to develop the national criteria for identifying and responding to this syndrome so that other states, other hospital systems can also be looking into this. As it turns out, these children happen to have the Covid-19 antibodies or be positive for Covid-19. But those were not the symptoms they showed when they came into the hospital system. It is a serious situation,” Cuomo said on Saturday.
The New York State Department of Health will also be partnering with the New York Genome Center and the Rockefeller University to conduct a genome and RNA sequencing study to better understand the disease and the possible genetic basis of the syndrome. “The Department of Health is on top of this. This is the last thing that we need at this time with all that’s going on, with all the anxiety we have. Now for parents to have to worry about whether or not their youngster was infected and again symptoms that don’t even seem like the symptoms we associate with Covid-19. So, we still have a lot to learn about this virus, and every day is another eye-opening situation,” said Cuomo.
Though most children who get Covid-19 experience only mild symptoms, in the UK too, a possible link has been reported between pediatric Covid-19 and serious inflammatory disease.
The New York State Department of Health had earlier issued an advisory on the condition. The purpose of the health advisory is to inform healthcare providers of the condition, as well as to provide guidance for testing and reporting. “Recently, the novel coronavirus has been reported as possibly linked with a pediatric multi-system inflammatory syndrome disease – Pediatric Multi-System Inflammatory Syndrome potentially associated with Covid-19. Healthcare providers, including hospitals, are required to report to the Department of Health all cases of pediatric multisystem inflammatory syndrome potentially associated with COVID-19 in those under 21 years of age,” says the advisory.
According to the advisory, the inflammatory syndrome may occur days to weeks after acute Covid-19 illness. The full spectrum of disease is not yet known. It can include persistent fever, abdominal symptoms, rash, and even cardiovascular symptoms requiring intensive care. Accordingly, early recognition by pediatricians and referral to a specialist including critical care is essential, say experts.
“This inflammatory syndrome may occur days to weeks after acute COVID-19 illness. The syndrome may include a child presenting with persistent fever, inflammation (for example, neutrophilia, elevated C-reactive protein and lymphopenia), and evidence of single or multi-organ dysfunction (shock, cardiac, respiratory, renal, gastrointestinal or neurological disorder). This may include children meeting full or partial criteria for Kawasaki disease,” cautions the advisory.
It further says, “(The syndrome may include) exclusion of any other microbial cause, including bacterial sepsis, staphylococcal or streptococcal shock syndromes, and infections associated with myocarditis such as enterovirus. Clinicians should not delay seeking expert advice while waiting for results of these investigations.”
Pediatricians and specialists have been advised to elicit any recent history of illness with Covid-19 or close contact with individuals who are known to have Covid-19 in children presenting with symptoms that are compatible with the inflammatory syndrome. “The majority of patients who have presented with this syndrome have tested positive for SARS-COV-2 (the virus that causes Covid-19) or corresponding antibodies. Some tested positive on diagnostic, molecular testing for SARS-COV-2, others were positive on serological testing for corresponding antibodies,” emphasizes the advisory.
Hospitals have also been asked to perform a diagnostic and serological test to detect the presence of SARS-COV-2, or corresponding antibodies in patients who are under 21 years of age and present with symptoms compatible with the inflammatory syndrome.