Children falling ill with baffling Covid-19 related illness
One child, 8 years old, arrived at a Long Island hospital near death last week. His brother, a Boy Scout, had begun performing chest compressions before the ambulance crew arrived.
In the past two days alone, the hospital, Cohen Children’s Medical Centre, has admitted five critically ill patients — ages 4 to 12 — with an unusual sickness that appears to be somehow linked to Covid-19, the disease caused by coronavirus.
In total, about 25 similarly ill children have been admitted there in recent weeks with symptoms ranging from reddened tongues to enlarged coronary arteries.
Since the coronavirus pandemic began, most infected children have not developed serious respiratory failure of the kind that has afflicted adults. But in recent weeks, a mysterious new syndrome has cropped up among children in Long Island, New York City and other hot spots around the country, in an indication that the risk to children may be greater than anticipated.
The number of children in the US showing signs of this new syndrome — which was first detected in Europe last month — is still small, and none is known to have died.
“This is really only a disease that has been clear for two weeks now, so there is so much we’re trying to learn about this,” Dr James Schneider, Cohen Children’s chief of paediatric critical care, said.
No solid data yet exists about how many children have fallen ill with what doctors are calling “paediatric multisystem inflammatory syndrome”.
In some patients the syndrome seems to match a rare childhood illness called Kawasaki disease, which can lead to inflammation of the blood vessels, especially the coronary arteries.
The symptoms of Kawasaki disease often start with a fever and a rash, but when undiagnosed and untreated, the illness can lead to serious heart conditions, such as coronary aneurysms.
While some patients in recent weeks have presented as if they had classic Kawasaki disease, others have been far more seriously ill, with falling blood pressure, heart inflammation and symptoms consistent with toxic shock, said Dr Nadine Choueiter of the Children’s Hospital at Montefiore in the Bronx.
On Tuesday, the New York City Health Department issued a bulletin, asking doctors to report any cases of the syndrome. The bulletin said the health authorities in the city knew of 15 cases, involving patients age 2 to 15, who had been in intensive care since April 17. But based on interviews with doctors, the number of cases in the city appears to be higher.
“I would say so far we have seen 13 patients,” Choueiter said of the number of children treated for the syndrome at just her hospital.
Still, doctors were reluctant to speculate how widespread it might be across the city. “That is the question we are constantly thinking about, and I don’t think we know the answer,” Choueiter said.
Doctors in New York have noted that cases of the new syndrome began to appear a month or so after a surge of Covid-19 in the region. That timing suggests “it’s a post-infectious immune response to this,” said Dr Leonard Krilov, chairman of pediatrics at NYU Winthrop Hospital in Mineola, New York.