The Register Citizen (Torrington, CT)
Doctors: Toxic shock could be linked to coronavirus in kids
For months, it seemed, one of the few positive aspects of COVID-19 was that most experts agreed it did not usually result in serious illness in children. But new evidence shows a possible link between the respiratory illness and an inflammatory syndrome that can require cardiac or respiratory support in some young patients.
While doctors say the complications do not appear to have surfaced in any Connecticut cases, they believe it’s likely just a matter of time.
On Monday, the New
York City Health Department reported that 15 children between the ages of 2 and 15 had developed a multi-system inflammatory illness, sharing characteristics of toxic shock syndrome or Kawasaki disease, which causes swelling in blood vessels throughout the body.
Only four of these patients tested positive for COVID-19, but another six might have been previous infected with the illness, according to blood tests.
“All patients had subjective or measured fever and more than half reported rash, abdominal pain, vomiting, or diarrhea,” the health department’s statement read. “Respiratory symptoms were reported in less than half of these patients.”
Though the statement mentions that cases such as these have popped up “elsewhere in the United States,” at least two Connecticut doctors said they’ve not heard reports of it here — yet.
Dr. Zane Saul, Bridgeport Hospital’s infectious disease chief, said he’s not yet heard of children in Connecticut developing these inflammatory conditions, but it’s likely to happen at some point.
“I imagine if it’s in (New
York), it will come here,” he said.
Dr. Dara Richards, chief medical officer at Bridgeport-based Southwest Community Health Center, said the center, which primarily serves the uninsured and underinsured population, hadn’t seen inflammatory illness linked to COVID-19, either.
“We have only had a few young children who have tested positive,” she said. “Those few had typical COVID symptoms, such as fever and cough, and their symptoms were mild. They did not require hospitalization.”
Saul said the idea that these inflammatory illnesses could be linked to COVID-19 is contrary to how most doctors believed the disease affects children.
“We didn’t see kids getting quite as ill and we thought because the immune system was too immature and didn’t overreact,” he said.
But inflammatory conditions are an immune response, Saul said, so it’s possible that children’s bodies are aggressively attacking the virus in some cases.
Though the New York cases all involved children hospitalized between April 17 and May 1, there have been indications for a while that there could be a link between COVID-19 and inflammatory conditions in children. On April 8, the American Academy of Pediatrics published an article about a case study of an infant who tested positive for COVID-19 and also was treated for Kawasaki.
Kawasaki is characterized in its first phase by a fever, rash, extremely red eyes and other symptoms. Children with the illness can develop vomiting, diarrhea and other symptoms as it progresses. In most cases, if treated properly, children recover from Kawasaki with few longterm effects, but it can lead to complications, including heart disease.
It’s alarming that these syndromes seem to be mirroring Kawasaki and toxic shock syndrome — a condition normally seen in menstruating women — because both of these can have serious complications, Saul said.
Like Kawasaki, toxic shock syndrome is often characterized by fever, rash and gastrointestinal symptoms.
“Toxic shock syndrome is a very serious illness,” Saul said. “You worry that it can lead to organ failure.”
He said these complications in children are fairly rare, but it’s still unclear what the future holds.
“This is constantly evolving,” Saul said.