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Inflammatory Syndrome in NYC/European
Kids Possibly Related to COVID-19
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Mark Mascolini
An inflammatory syndrome affecting multiple systems in 15 New York City children may be "potentially associated with COVID-19," according to the New York City Health Department [1]. Marked by persistent fever and features of Kawasaki disease or toxic shock syndrome, the pediatric inflammatory disorder has also appeared in some European countries [2].
The NYC Health Department alert notes that abdominal symptoms are common with the syndrome, and affected children may need intensive care for cardiac or respiratory support [1]. Children may have persistent fever and elevated inflammatory markers (such as CRP and troponin). Other signals include rash, abdominal pain, vomiting, and diarrhea. Fewer than half of the children had respiratory symptoms.
The NYC cluster includes 15 children 2 to 15 years old admitted to the hospital from April 17 through May 1, 2020. Four children had a positive PCR for SARS-CoV-2. More than half of these children required blood pressure support and 5 needed mechanical ventilation. None of the children had died at the time of the alert.
Clinicians in Italy, Britain, France, Spain, Switzerland, and Belgium reported similar cases, according to The New York Times [2]. Bergamo, where the Italian COVID-19 epidemic began, counted 20 cases of this pediatric inflammatory syndrome in April alone. Four hospitals in Paris recorded 20 cases, more than a dozen children in the UK have a similar syndrome, and Spain has a few dozen. Switzerland and Belgium also noted a few cases.
New York City health commissioner Oxiris Barbot told The Times parents should "call your doctor right away" if a child has "symptoms like fever, rash, abdominal pain or vomiting" [2]. The Health Department alert said clinicians who see a child with this syndrome "should immediately refer patients to a specialist in pediatric infectious disease, rheumatology, and/or critical care, as indicated" [1].
References
1. Daskalakis DC. 2020 Health Alert #13:Pediatric multi-system inflammatory syndrome potentially associated with COVID-19. New York City Health Department. May 4, 2020. https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/2020/covid-19-pediatric-multi-system-inflammatory-syndrome.pdf
2. Goldstein J. 15 Children are hospitalized with mysterious illness possibly tied to Covid-19. New York Times. May 5, 2020. https://www.nytimes.com/2020/05/05/nyregion/children-Kawasaki-syndrome-coronavirus.html
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