Parents, hospitals and clinics should expect to see more cases of a mystifying condition that seems to be affecting children after a bout with Covid-19, doctors said Wednesday.
The condition, called multisystem inflammatory syndrome in children, appears to be a post-viral syndrome, said Dr. Jeffrey Burns, a critical care specialist at Boston Children’s Hospital who has been coordinating a global group of doctors who compare notes on the condition.
It has affected at least 100 children in the United States, most of them in New York. But doctors in Kentucky, Massachusetts, Michigan and elsewhere have also reported cases.
“This multisystem inflammatory syndrome is not directly caused by the virus,” Burns said. “The leading hypothesis is that it is due to the immune response of the patient.”
Symptoms include: Persistent fever, inflammation and poor function in organs such as the kidneys or heart. Children may also show evidence of blood vessel inflammation, such as red eyes, a bright red tongue and cracked lips.
Not all of the affected children have tested positive for the coronavirus, but reports from Europe and from several cities in the United States show a link.
“There seems to be delayed responses to Covid infections in these kids,” said Dr. Moshe Arditi, a pediatric infectious diseases expert at Cedars-Sinai Medical Center in Los Angeles.
Burns believes more cases will turn up as Covid-19 affects more people. It’s a rare condition, but rare consequences of viral infections are seen more often when millions of people are infected.
“We can expect that each of the epicenters will see clusters of these emerging roughly four to six weeks later,” Burns said.
Most children are not seriously affected by the syndrome, Burns said. Most don’t even need treatment in the intensive care unit, he said, although a small number have died. “We do have proven treatments that we can use and are using,” he said. They include blood thinners and immune modulators.
The US Centers for Disease Control and Prevention is preparing a Health Alert Network notification to send to doctors across the country, an agency spokesman confirmed. Burns said the World Health Organization is also working to define the syndrome and alert doctors so they will know what to look for and how to treat it.
While the syndrome has features in common with Kawasaki disease and toxic shock syndrome, it’s different, Burns and Arditi both said. It will be important to study, because the response could help explain why children are so much less likely to be severely affected by Covid-19 than adults are.
“Understanding the child’s immune response could be a key to vaccine development and could also be a key to therapy for adults to understand why children are able to fight (Covid-19) off so well,” Burns said.