What parents need to know about the rare illness in children possibly linked to COVID-19
Experts believe a rare, mysterious illness appearing in children could be linked to COVID-19.
Symptoms of the virus, dubbed Pediatric Multisystem Inflammatory Syndrome (PMIS), have been compared to those of Kawasaki disease and toxic shock syndrome,
. However, it is being recognized as a "new entity," according to Dr. Luiza Petre, a cardiologist and professor of cardiology at Mount Sinai's School of Medicine in New York.
Kawasaki disease is a rare but serious illness believed to be triggered by the immune system's response to infection, but an official cause is unknown. CBS reported that children with Kawasaki experience a prolonged fever lasting several days, a skin rash and swollen lymph nodes in the neck; affected children can also develop redness in their eyes, lips, mouth, as well as the palms of their hands and soles of their feet, according to the National Institutes of Health.
Most children recover, but if left untreated, Kawasaki can cause cardiac issues and become life-threatening. Toxic shock also causes fever and a decrease in blood flow but is triggered by a bacterial infection.
Kawasaki disease mostly occurs in children under the age of 5, while a study of PMIS cases in Italy found an average age of 7½.
CBS reported that while an understanding of PMIS is still evolving, children with the syndrome also experience a prolonged fever, rashes, change in the color of their skin or their lips, swollen glands and red eyes. What is different, however, is that children suffering from PMIS complain of abdominal pain, nausea, vomiting, diarrhea and chest pain.
"What we're seeing is the immune system is actually going into overdrive, impacting the body in a negative way," Dr. Jake Kleinmahon, a pediatric oncologist at Ochsner Hospital for Children, in New Orleans, who has treated several children for the illness, told CBS News. "Some of these patients are having inflammation of their coronary arteries, and you can have basically a heart attack."
According to Dr. Sean O'Leary, vice-chair of the American Academy of Pediatrics' Committee on Infectious Diseases, the level of inflammation in the heart tends to be higher with PMIS, as compared to Kawasaki disease.
Altogether, the syndrome has shown to be more severe than Kawasaki. "That's what's concerning," Petre told CBSN. "And a lot of (PMIS) cases do require ICU, almost 80% of them."
According to CBS, the disease has been reported in more than 100 children in New York, and experts in Tennessee are looking into the disease.
confirmed that they investigated two cases of the disease. Both children tested negative.
Doctors in Italy announced Wednesday that they found evidence linking the coronavirus to PMIS. Eight out of 10 children they studied with PMIS had antibodies to COVID-19, indicating that they had been infected.
The fact that the syndrome is appearing in places where coronavirus is prevalent suggests that there could be a correlation, O'Leary said. He noted that it's too early to be certain.
CBS News senior medical correspondent Dr. Tara Narula said, "It's important to stress that in the grand scheme of the pandemic, this is rare. We're still learning a lot more about it."
CBS reported that, while the majority of children with PMIS symptoms reported in New York also tested positive for COVID-19, some have not.
According to O'Leary, PMIS cases seem to appear about a month after a peak of COVID-19 cases in an area. If the syndrome is brought on by a COVID-19 infection, the lag time for PMIS symptoms is a curious feature, he said. "It's almost more surprising that most of these kids are (COVID-19) positive."
CBS reported that if a child does present PMIS symptoms, it's important to contact your doctor. Experts said that if a child has a fever that doesn't go down and is resistant to medication for more than one day, you should reach out to your doctor.
The American Academy of Pediatrics released guidelines for parents earlier this week advising them to call their pediatrician if they notice any of the following symptoms:
a fever that won't go away
abdominal pain, diarrhea or vomiting
rash or changes in skin color
your child seems confused or overly sleepy
"In this syndrome, early intervention is critical as children can decompensate very quickly, and they should seek medical attention immediately," Petre said.
According to Petre and O'Leary, if a child is admitted for PMIS, their primary treatment will be supportive care. Fluids and medication would likely be administered to maintain blood pressure, as well as anti-inflammatory medication like steroids or immunoglobulin (IVIG).
"If you're not really aware of this syndrome that's being described, it could easily be missed," said Kleinmahon. "Fortunately children overall are very resilient. And almost all of the cases, if we're able to knock down the inflammation and get them past the beginning stages of this, they're usually doing very well."