Children contracting rare inflammatory illness
Children are showing up in emergency rooms across southeast Michigan with a rare inflammatory syndrome that has been linked to COVID-19 infection and exposure.
In New York, nearly 90 of cases of pediatric multisystem inflammatory syndrome are being investigated by the state’s department of health.
Three of these children have died from the syndrome, which presents symptoms similar to Kawasaki disease, a toxic-shocklike inflammation that constricts blood vessels and arteries, causing low blood flow to the heart. Common symptoms include a high temperature lasting over five days, a rash, cracked lips, swelling of hands and feet, and redness in both eyes.
Dr. Rudolph Valentini, Chief Medical Officer at Children’s Hospital of Michigan, said around 20 to 25 children have been admitted to the hospital with this syndrome, ranging in age from three months to 18 years old, most of which have gone straight to the ICU for treatment.
He said almost all of these patients have been admitted with a fever and a rash with other symptoms including pink eye, diarrhea, vomiting, intense abdominal pain, inflamed tongues, dry and cracked lips, and swollen lymph nodes.
“We are treating around six to 10 of these patients right now,” he told The Oakland Press. “Most of these patients do not actively have COVID-19 infection, but most have likely been exposed to COVID-19 and have mounted an inflammatory response to COVID-19. Most of these patients are COVID-19 negative, but appear to have an antibody in their system suggesting they have been exposed to the virus.”
With nearly 90 reported cases, the State of New York will be working with the New York Genome Center and Rockefeller University to determine what is causing the illness, according to The New York Times. Last week, the New York City Health Department issued a bulletin asking doctors to report any new cases of the syndrome.
Valentini, when asked if there’s a direct link between COVID-19 and pediatric multisystem inflammatory syndrome, said he has never seen so many cases of Kawaski Diseaselike syndrome “coming this fast and furious that are much, much sicker than traditional Kawaski Disease patients.” He added that the syndrome has been seen most often in children that may have had the virus, but no longer do.
“You have a huge number of COVID-19 cases and a huge number of severe Kawaski Disease-like state that are atypical,” he said. “Some of these cases, around 15 percent, have active COVID-19 infection while the majority of the remaining patients have evidence of positive COVID-19 antibodies...It’s hard to deny the association.”
He said that he wants to get the message out to pediatricians because at first glance, symptoms of pediatric multisystem inflammatory syndrome “don’t sound that exciting.” He said none of the hospital’s patients, confirmed with pediatric multisystem inflammatory syndrome, have died.
“The majority of our patients have ended up in the ICU” he said. “They can become very unstable very quickly. Many of these patients have required very aggressive IV medication, including medications to keep the heart beating stronger and to raise blood pressure. Their hearts have become weak and can’t sustain a normal blood pressure.”
Three children have been treated with the syndrome at Beaumont Hospital in Royal Oak.
Dr. Bishara Freij, Chief of Pediatric Infectious Disease at Beaumont Hospital-Royal Oak, said the children, two girls and one boy ranging in age from 7 to 13, were admitted to the hospital over the past week.
The two girls tested positive for COVID-19, while the boy tested negative, but is “highly suspected” to have the virus.
“What we know is that COVID-19 is associated with this hyperinflammatory state, which has been described as a cytokine storm” he said. “The immune system has gone into overdrive. These intense inflammatory mediators are the things that actually injure us. The pediatric multisystem inflammatory syndrome that seems to be related to COVID-19 is basically the same idea.”
Freji said in addition to persistent fever, these patients are also complaining of gastrointestinal issues such as stomach pain, vomiting, and diarrhea. He said those symptoms evolve into eye redness, in most cases, and changes with the lips.
He said adults have exhibited symptoms similar to pediatric multisystem inflammatory syndrome, but that symptoms present differently, more pure, in children due to age and overall health.