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At first, the news that COVID-19 does not always affect children as severely as it strikes adults was welcome relief. At least that’s what clinicians initially understood about the disease caused by. Now doctors and scientists are rethinking this hypothesis, having identified clusters of cases that point to a potentially dangerous syndrome that they believe is linked to COVID-19 in children, but with different pathology and sometimes fatal results .
Many of these affected children were admitted to intensive care and placed on respiratory support. Some have reportedly suffered heart damage and other organ failure. The Centers for Disease Control and Prevention have confirmed that at least three children have died, but doctors believe there are likely more. With clinical symptoms more closely reflecting Kawasaki disease and toxic shock syndrome than symptoms of COVID-19, doctors still know a lot about this newly observed disease.
This raises difficult questions. What is the disease called and how does it affect children? How deadly is it? How is it treated and will it delay the reopening of schools? This story is based on available information from sources such as the CDC and the World Health Organization, and will continue to be updated as new details become available. It is not intended to serve as medical advice.
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What is the name of the disease and how is it related to the coronavirus?
The CDC and the WHO have dubbed this condition “childhood multisystem inflammatory syndrome” (PDF) or MIS-C. It is also called both “pediatric multisystem inflammatory syndrome” and “pediatric hyperinflammatory syndrome”.
In the early stages of the pandemic, doctors noted that it appeared that fewer children than adults had enough COVID-19 symptoms to require a hospital stay. A series of studies quickly confirmed these suspicions. They have shown how some children get sick, but much less often than adults. And it seemed that children could certainly spread the disease, but adults transmitted it more quickly. It was learned that the children were relatively safe from the worst effects of the virus and the parents breathed a sigh of relief.
Over time, however, groups of unusually severe pediatric cases began to emerge. Most of these children were positive, if not for the coronavirus itself, then for the antibodies which suggested that they had been infected at some point. However, these children did not arrive at the hospital with typical COVID-19 complaints. Notably, reports indicate that, although they had fewer breathing problems than expected, these children were actually much sicker than many adult patients. They were among the first pediatric patients identified (PDF) with this new syndrome.
The reason experts believe the disease affecting these children is linked to the new coronavirus and COVID-19, the disease it causes, is due to the number of positive tests for it. It is true that tests for some of the children with these symptoms came back negative, but doctors have raised concerns about the accuracy of some COVID-19 tests as a possible explanation for these exceptions.
Because many of these patients tested positive for antibodies – which means they had contracted the coronavirus perhaps weeks before – doctors began to suspect that what was happening was not the direct result of the virus itself, but rather a kind of reaction from their bodies were faced with an infection that had already gone.
What happens to children who are supposed to receive COVID-19?
Symptoms reported by patients and doctors vary. Doctors observed persistent fever, red eyes and rashes, as well as low blood pressure, inflammation, pale and sometimes blue lips and skin, difficulty breathing, and lethargy.
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The most serious reports describe blood clots, chest pain, increased heart rate and organ failure, including, in extreme cases, cardiac arrest. Children with MIS-C do not always complain of breathing problems as doctors expect COVID-19 patients. But beyond these and a few other symptoms, doctors admit that little is known for sure about this disease. All they say is certain, it requires immediate medical attention.
What are Kawasaki disease and toxic shock? How are they related to MIS-C?
Kawasaki disease is an inflammatory disease of unknown cause that mainly affects children 5 years of age and under. Toxic shock syndrome is a complication that results from a bacterial infection and also causes inflammation. It is more deadly than Kawasaki disease, but the two conditions share a number of symptoms with MIS-C, including fever, red eyes, rashes, and body pain. The MIS-C is however considered to be separate.
This is what the survivors looked like
Knowledge about multisystem inflammatory syndrome remains limited, but some children who have recovered have told the media about their experiences.
A teenager, speaking to the New York Times, described this feeling as “as if someone had injected you with direct fire” while hospitalized for heart failure.
A 12-year-old girl told The Washington Post that she remembered having “weird” bluish lips and feeling “super tired” before doctors said she had a cardiac arrest.
Doctors say another 12-year-old girl developed a blood clot that stopped her heart. “I felt like someone was stabbing my leg,” she told NBC, who said it took 45 minutes of CPR to start over.
How does coronavirus cause all of these symptoms?
So far, no one knows for sure, but some doctors believe it may be a kind of delayed reaction of the child’s immune system that is abnormal and unusually aggressive. Doctors speculate that while trying to fight the virus, their immune system overreacts and begins to damage normal and healthy cells, like those of their organs. They suggest that this could also be the cause of the dangerous fall in blood pressure often observed.
How common is MIS-C? How many children have had it?
A recent survey has identified more than 200 cases of the disease, but with a total number of coronavirus infections exceeding 5 million confirmed cases worldwide, experts say that this disease is still quite rare and that the vast majority of patients have so far responded well to treatment. Most have fully recovered.
When was MIS-C discovered and how does it relate to COVID-19?
In early April, a prepublication article in the journal Hospital Pediatrics reported an infant admitted and diagnosed with both Kawasaki disease and COVID-19. Since then, doctors have reported clusters of pediatric COVID-19 cases with Kawasaki disease (PDF) and related symptoms, such as persistent fever, reddened eyes, rash, and joint and abdominal pain.
Are there any treatments?
There is currently no official or known treatment for MIS-C or coronavirus (although there arealready in clinical trials). However, doctors have reported positive results with the treatments they have prescribed.
New research published in the circulation journal of the American Heart Association reports that children with heart failure as a result of this syndrome who were then treated with a combination of steroids and antibodies acquired from donated blood – a treatment called immunoglobulin – have massively recovered. Cardiac function would have been restored within a few days in most cases thanks to this standard anti-inflammatory therapy.
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The information in this article is for educational and informational purposes only and is not intended for medical or health advice. Always consult a doctor or other qualified health care professional for any questions you may have about a medical condition or health goals.