The novel coronavirus, known as SARS-CoV-2, which is responsible for COVID-19 disease, causes a broad range of health effects.
Because of the newness of the virus and the disease, medical science continues to learn about disease manifestations in different groups. One thing that has become clear is that not all groups are affected equally.
For instance, it has become clear that older adults and those with chronic health conditions, such as heart disease, diabetes and chronic obstructive pulmonary disease, have higher rates of severe illness and death.
While it appears that children have lower rates of severe illness at this time, we have also learned that the virus can cause unique problems, albeit rarely, in this younger age group.
In mid-May, the U.S. Centers for Disease Control and Prevention began receiving reports of a clinical syndrome among children infected with SARS-CoV-2, the virus that causes COVID-19. The syndrome resembles a condition known as Kawasaki disease, which was first described by its namesake in Japan in the late 1960s. Kawasaki disease causes widespread inflammation, especially in children younger than 5.
The Kawasaki-like syndrome associated with coronavirus infection has been named multisystem inflammatory syndrome in children (MIS-C). MIS-C is a serious disorder causing inflammation in children and adults younger than 21, arising days to weeks after infection with SARS-CoV-2 virus.
According to CDC criteria for diagnosis, the syndrome includes fever, laboratory evidence of inflammation, severity of illness requiring hospitalization and involvement of multiple organ systems, including heart, kidney, lung, blood, intestinal, skin and/or the nervous system.
Several hundred cases have been reported. Studies report the majority of affected children were previously healthy, develop the syndrome usually two to four weeks after infection and about 80% require intensive care treatment.
Unlike Kawasaki disease, which predominantly affects children of Asian descent, MIS-C appears to affect children among all ethnic and racial backgrounds. Because this condition is only recently recognized, what is not clear is whether it potentially represents a larger problem connecting SARS-CoV-2 viral infection in children with various inflammation-related health problems.
Symptoms of MIS-C include: fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes and feeling extra tired. Not all children have the same symptoms. Parents should seek emergency care if their child experiences trouble breathing, chest pain or pressure that won’t go away, new confusion, inability to wake or stay awake, bluish lips or face and/or severe abdominal pain.
Treatment is largely supportive, but early recognition and hospitalization for affected children is important.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.