New virus syndrome rising, especially among Latino children.
Latino youngsters most in jeopardy from symptoms
As COVID-19 cases increase among adults, they have also increased in children, along with cases of a new inflammatory syndrome. And, like the adult population, Latino kids have borne a disproportionate brunt of the cases.
At least seven California children have died from COVID-19 since the pandemic began, more than 350,000 kids have tested positive for the virus, and the number of youngsters diagnosed with a new, rare inflammatory syndrome continues to spread.
All of these statistics are on the rise just as a new highly contagious strain of the virus is worrying parents and experts alike and as the state tries to move toward reopening schools next month.
“We are at a critical time because the overall number of cases of COVID are increasing so much,” said Dr. Jackie Szmuszkovicz, pediatric cardiologist at Children’s Hospital Los Angeles. “We are seeing more children with MIS-C the last few weeks following that big increase (of cases)
in the community.”
MIS-C, or Multi-system Inflammatory Syndrome in Children, is the name of a new inflammatory syndrome that afflicts a small number of kids three to six weeks after they experienced coronavirus, even if they had mild or no symptoms at all.
While children have been spared some of the worst effects of the coronavirus and the high death toll seen among adults, the youngest Californians are still at risk, especially given the current surge. Kids usually experience mild to no symptoms of the infection, but it’s what happens to a small number of them a few weeks afterward that has doctors worried. Pediatric doctors are preparing for a wave of inflammatory syndrome cases three to six weeks after the current surge especially with the new more transmissible variant, Szmuszkovicz said.
Kids do get sick
Although severe COVID-19 has been uncommon in children, there has been a tiny uptick in more serious cases recently, said Dr. Erica Lawson, a pediatric rheumatologist at UCSF Benioff Children’s Hospital San Francisco.
“We are seeing more kids on the far end of the curve, who are sick enough to be admitted,” she said. “It’s because of the higher numbers in the community. If you have a prevalence in the community, the more cases you have the more severe cases you will have.”
Dr. Behnoosh Afghani, a pediatric infectious disease expert at UCI Health in Orange County, hopes that the spread of the vaccine will start to decrease the number of infections in adults and therefore also contribute to fewer infections among children. While children under 16 cannot be vaccinated, if more adults around them are vaccinated, it will increase protection for children, she said.
California’s Department of Public Health reports that at least six minors have died from COVID-19 since the pandemic began, and one more died in Los Angeles that has not yet made the state’s count, according to Children’s Hospital Los Angeles.
The state does not identify which of the children had the inflammatory syndrome and how many had COVID-19 at the time of their death. It is also not releasing information about where they lived or their ages, although there has been a confirmed death in Orange County, one in the Central Valley and two in Los Angeles.
MIS-C, the rare inflammatory syndrome, was discovered last year in children who had previously had coronavirus. Originally it was thought to be Kawasaki disease, a post-infection syndrome that afflicts young children, but physicians connected the new syndrome to COVID-19. It is marked by overwhelming inflammation in the body that sometimes impacts major organs and can lead to heart failure. Children develop a fever, some have abdominal pain, vomiting or diarrhea, rash, are severely fatigued and have red eyes.
So far, 176 children in California have been diagnosed with the inflammatory syndrome.
“These kids develop a lot of inflammation in their bloodstream and could have multiple organ systems affected, including the heart,” Lawson said. The San Francisco hospital and its campus in Oakland have treated about 20 children so far with the syndrome but have had no deaths, she said. Most of the children have been Latino.
Statewide, Latino kids account for 64% of COVID-19 cases among kids under 18 when race and ethnicity is known, but make up only 48% of the state’s children, according to the state Department of Public Health.
Lawson reasons that the child cases reflect what is going on with adults. In California, Latinos account for 54% of cases among adults. They are most often essential workers — like drivers, restaurant cooks and grocery workers — and sometimes live together in crowded conditions with extended family members or other family groups where it is difficult to isolate.
Nationally, racial and ethnic trend lines among children are also mirroring adults, according to the Centers for Disease Control and Prevention. The majority of children in the U.S. who have been diagnosed with the infection and the inflammatory syndrome have been Latino or Black.
As of Jan. 8, there were 1,659 cases of MIS-C in the U.S. among kids and 26 deaths. The average age is 8 and more than 70% of the cases occurred in Latino or Black children, according to the federal agency.
Pediatric experts advise parents to be on the lookout for the signs of MIS-C a few weeks after their children or they are sick with the virus. Some families may not realize their children had the virus until they show signs of the syndrome, Szmuszkovicz said.
“We really want to encourage people not to delay care because we are seeing earlier treatment leads to the best outcomes,” she said. “In some cases, the syndrome can, in its most severe form, affect the heart function and cause coronary aneurism.”
Children’s Hospital Los Angeles has cared for the largest group of afflicted kids — at least 47 so far — ranging in age from 4 months to 17. Two of the children died in December, Szmuszkovicz said. The hospital would not release any other information on the children due to patient privacy.
Treatment for MIS-C appears to work well if administered early on, she said. Most children get IV fluids and others also need medication like steroids and intravenous immunoglobulin, while some go on to need respiratory support, from oxygen to a ventilator.
In Los Angeles, Alexis Winter has been keeping an extra close eye on her two young daughters. Her whole family, including her 3-yearold and 14-month-old, had COVID-19 last month.
“It’s terrifying, and I try not to obsess over it,” Winter said, noting her children are nearly at the one-month mark since their infections.
She said she doesn’t know how the family got the infection and that they had been very careful not to interact with others because Winters is high-risk.
It started with her husband and then Winter and the children got sick. Her daughter, 3, threw up in bed and didn’t feel well the next day. Then her baby was super fussy and had a raspy voice. Neither of the girls had a fever, she said.
“For the kids, the complications are not worth the risk,” she said. “If I could go back in time and figure out what happened, I would. Because it’s scary to know they had the virus and were exposed to it.”