NORTH CAROLINA, USA — National and global health agencies are alerting doctors to be watchful for a rare, but serious, complication weeks after a COVID-19 infection in kids that can cause irritability, fever, rash, low blood pressure, vomiting, diarrhea, and even death.
While the underlying cause is unknown, the current belief is that it’s linked to the body’s immune system mistakenly attacking itself, similar to a condition called Kawasaki disease -- a rare set of symptoms that is also not well understood.
There have been no cases of the syndrome in the Piedmont-Triad, Dr. Christopher Ohl of Wake Forest Baptist Health told reporters this past Thursday.
Across North Carolina, there have been no cases reported to the N.C. Department of Health and Human Services, a spokesperson told WFMY late Saturday.
But because the coronavirus-linked syndrome is newly recognized, the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have called on doctors to report any possible cases so experts can learn more.
Here’s what we know – and don’t know – about the syndrome in kids linked to coronavirus, which experts are currently calling “multisystem inflammatory syndrome in children associated with COVID-19.”
WHAT EXACTLY IS IT?
The syndrome occurs in kids and teenagers who were recently exposed to COVID-19.
In medicine, a “syndrome” a collection of signs and symptoms that, taken together, represent one condition.
While it’s too soon to know exactly how long after viral infection the condition happens, the CDC’s working case definition says the syndrome can occur within about four weeks after COVID-19 exposure.
Kids and teens develop fever lasting several days, plus any number of other symptoms including low blood pressure, stomach pain, vomiting, diarrhea, and problems with the heart, kidneys, arteries, and brain. Lung and breathing problems did not happen in all of the kids with the syndrome.
A very small number of children have reportedly died from the syndrome: at least three minors in New York and one in the UK.
While the true cause is still being worked out, health experts believe the body's own immune system goes into overdrive from a coronavirus infection, and then begins to mistakenly attack itself, causing the inflammation that doctors have seen in nearly every part of the body.
Health experts have compared this mystery syndrome to Kawasaki disease, which has similar symptoms and an unknown underlying cause.
WHAT IS KAWASAKI?
To be clear, Kawasaki disease is different from the seemingly new post-COVID syndrome, although they share similar features.
Kawasaki disease, first described officially in 1967, is a condition in kids under 5 where the body’s blood vessels become irritated and inflamed, according to the CDC and UpToDate. It’s primarily seen in East Asia, but occurs all around the world.
In the U.S. the condition is very rare – with between 9 and 19 cases per 100,000 kids every year.
It causes children to develop diarrhea, vomiting, abdominal pain or coughing. Then 7-10 days later, kids develop redness and pain of the eyes and lips, rash, swollen lymph nodes, and swelling of the hands and feet. It can also lead to heart disease.
If you’re confused about the wide range of symptoms, you’re in good company. Doctors and scientists don’t know the underlying cause of Kawasaki. But they believe it may be caused by a recent infection confusing the body’s immune system in certain people who are genetically susceptible, resulting in the army of immune cells mistakenly attacking a person’s own arteries.
Fortunately, there are treatments for Kawasaki. Doctors give kids infusions of immunoglobulin, a type of immune system protein, which appears to calm down the inflammation and overactive immune system, although its exact mechanism it also not known.
HOW COMMON IS IT?
The short answer is that health experts believe the inflammatory coronavirus-linked syndrome rare -- but are currently studying the condition as the COVID-19 pandemic continues.
New York was the first city in the U.S. to officially send notice the condition in early May, but medical experts in other countries, like the United Kingdom and Italy, reported seeing cases before that.
This past week, New York’s Governor said health officials had confirmed the condition in 110 children in the state. Even though there are almost certainly more cases, it’s worth noting that this condition impacts a small group of kids among the millions of people under age 21 in the state.
Dr. Christopher Ohl, an infectious disease doctor at Wake Forest Baptist Health, spoke about the inflammatory condition seen in kids during his weekly COVID-19 briefing this past Thursday, May 14.
"It's unusual, its rare," Dr. Ohl said to reporters. "I know of no cases here in the triad. Now that doesn't mean that I have a 100 percent knowledge of every case in the triad, but I don't think we've had any here."
"If you look at the numbers from other states, for a place like here in North Carolina, you would only expect maybe 20 to 50 cases over the entire state in everybody. So it's not a real common syndrome," Ohl said.
WFMY News 2 reached out to the North Carolina Department of Health and Human Services asking about any reports of the inflammatory syndrome in kids seen after a COVID-19 infection
“We do not have any confirmed cases at this time,” the NCDHHS communications manager said later Saturday. “We are monitoring for cases both with syndromic surveillance and through our Public Health Epidemiologists.”
HOW IS IT TREATED?
While the CDC did not issue and treatment recommendations, an article from the American Academy of Pediatrics (AAP) offers insight.
“Intravenous immunoglobulin and supportive care have been common approaches,” the article states, quoting Dr. Sean T. O'Leary, a member of the AAP Committee on Infectious Diseases.
COULD MY CHILD DEVELOP IT?
Like any other rare condition that can be serious, such as Kawasaki, it’s a good idea to be informed.
If you do notice your child has high fever, along with the other symptoms listed above, health experts recommend you seek medical attention.
Dr. Ohl said in the press conference that it's unlikely this rare syndrome would have any real impact on schools remaining closed or reopening.
OTHER STORIES
FACTS NOT FEAR
Remember facts, not fear when talking about the coronavirus. You should take the same measures recommended by health leaders to prevent the spread of the flu and other viruses. That means washing your hands, avoiding touching your face, and covering coughs and sneezes.
WHERE YOU GET INFORMATION ABOUT THE CORONAVIRUS IS IMPORTANT
It is important to make sure the information you are getting about the coronavirus is coming directly from reliable sources like the CDC and NCDHHS. Be careful not to spread misinformation about coronavirus on social media.
NC CORONAVIRUS HOTLINE
The state also has a special hotline set up where you can call 866-462-3821 for more information on the coronavirus. You can also submit questions online at ncpoisoncontrol.org or select chat to talk with someone about the virus.
You can also text keyword VIRUS to WFMY News 2 at 336-379-5775 to find out more information.
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