A baffling condition called Multi-Inflammatory Syndrome in Children (MIS-C) started showing up in kids about three weeks after the peak of the coronavirus pandemic passed through, a team at a large New York health system reported Monday.
The team at Northwell Health reported on 33 cases of the syndrome, which many doctors believe is some sort of delayed response to a coronavirus infection.
All 33 children recovered with treatment, the team reported in the Journal of Pediatrics. Dr. Charles Schleien, who chairs the pediatrics department at Northwell’s Cohen Children’s Medical Center in New Hyde Park, said doctors were at first mystified by what was happening.
“We were pretty shocked as it was playing out,” Schleien told CNN on Monday. “The whole syndrome came out of the blue. We had been comfortable for months [in the belief] that kids weren’t affected all these months by coronavirus.”
The flow of affected children peaked about five weeks after Covid-19 hit New York City and the surrounding areas hard, Schleien and colleagues reported in the Journal of Pediatrics. “These are families I am sure thought they were off the hook,” Schleien said.
Many showed up in shock, with plummeting blood pressure that required immediate treatment.
“We treated these kids as they were coming in having no idea what it was,” Schleien added. As many other medical centers have reported, the symptoms at first looked like Kawasaki Disease, a rare syndrome that usually affects very young children.
“We treated them as though they had Kawasaki Disease despite the age range,” Schleien said. The children with MIS-C ranged in age from 2 to 17. Almost all had gastrointestinal pain and diarrhea, the team reported.
They also had clear evidence of inflammation as shown on blood tests, and 79% of them required intensive care. All tested positive for coronavirus. Schleien said the team excluded a handful of other children who did not test positive. Other teams have reported that MIS-C patients had no symptoms of infection before, but that most of them later tested positive for antibodies to coronavirus, indicating a past infection.
All got treatment of some sort, including aspirin and intravenous immune globulin (IVIG), a standard Kawasaki treatment. Some also got the antiviral remdesivir or strong anti-inflammatory medications normally used to treat conditions such as rheumatoid arthritis.
All recovered and Schleien said he does not know which treatments helped or hurt. Some may have heart damage.
“They are all going to be seeing cardiologists for a while yet,” Schleien said.
He said parents and pediatricians need to make sure that any children with lasting fevers and diarrhea get examined right away.