COVID-19-linked ailment seen in at least 10 children

Connecticut patients with inflammatory syndrome average 8.3 years old

The 8-year-old boy arrived at Connecticut Children’s with stomach pain, a rash and cracked, peeling lips. His blood pressure was dangerously low.

The boy had no underlying health issues but an antibody test suggested he had been infected with COVID-19 at some point.

“He had low blood pressure and his oxygen saturation was low,” said

Chris Carroll, a critical care doctor at Connecticut Children’s. “What seemed like a perfectly healthy boy with a stomach problem was now in the intensive care unit with a life threatening syndorme.”

The boy is one of at least 10 pediatric patients in Connecticut diagnosed with Multi-System Inflammatory Syndrome in Children (MIS-C.) Symptoms include fever, rash, inflammation and shock.

Carroll stressed that the syndrome is extremely rare. There have been an estimated 10 to 20 Connecticut patients who may meet the diagnostic

criteria for the syndrome, in a state with 800,000 to one million children.

The average patient was 8.3 years old. More than 60% of those diagnosed with the syndrome were boys and three-quarters of them had no underlying health issue, Carroll said.

Patients began showing up with the mysterious syndrome in pediatric emergency rooms around the country in March and April, Carroll said, just as the COVID-19 pandemic was taking hold. Carroll and his colleague,

Dr. Robert Parker, a pediatric intensivist at Connecticut Children’s, participated in a new study of MIS-C.

Some of the patients were quite sick — 20% needed a ventilator and 80% required a stay in the intensive care unit. All of the Connecticut patients have recovered, Carroll said. However, there have been at least four deaths linked to the syndrome.

Overall, there have been 186 cases reported in 26 states, according to the study, published in the New England Journal of Medicine. The syndrome affects pediatric patients, defined as those younger than 21.

The second study conducted by the New York state health department found another 95 confirmed cases of MIS-C and two deaths.

Health experts around the world are working to better understand the syndrome, especially as students in Connecticut and other states prepare to return to the classroom in September.

In Connecticut, those researchers include Dr. Derya Unutmaz, a professor at The Jackson Laboratory, and Dr. Juan C. Salazar, physician-in-chief at Connecticut Children’s, who is using the blood samples to explore how the children’s immune systems respond to MIS-C and COVID-19.

The symptoms of MIS-C resemble those of Kawasaki Disease and toxic shock. But those suffering from the new syndrome were generally older, and sicker, than those afflicted with Kawasaki Disease. And in each case, they had become ill two to four weeks after being infected or exposed to the new coronavirus.

“They either had a mild illness or were unaware they had COVID-19,‘’ Carroll said.

The syndrome is new and much about it is unknown, including its possible long-term complications, Carroll said. But researchers believe it could be an auto -immune response to COVID-19.

“We’re still trying to figure out the path of this infection but it seems to be an inflammatory response,‘’ he said. “We presume its related to the body’s immune system being revved up in a way that it starts to effect other organs.”

With coronavirus infections climbing in other states, Carroll and other public health experts worry that cases of MIS-C could increase as well.

“Clinicians in regions of the country where COVID-19 is peaking should be aware of this syndrome in the weeks and months following a rise in cases,” he said. “Although the COVID-19 pandemic seems to have spared children from severe respiratory infections, the new syndrome, albeit rare, is a severe and lifethreatening condition that needs attention.”