Health care providers are working to understand the recent surge in a severe pediatric illness related to coronavirus where kids show symptoms similar to Kawasaki disease or toxic shock syndrome, and in some cases heart failure.
“It’s usually when the virus stimulates the immune system, the immune system fights it off, but then, for whatever reason, keeps attacking the body,” said Dr. Jennifer Owensby, interim medical director of the pediatric ICU at Bristol Myers Squib Children’s Hospital. “Most of the cases we’ve seen, and elsewhere, have been four to six weeks after infection, but it could be as short as a week, it could be as long as seven weeks. But what is becoming clear is there is no clear picture.”
Owensby point out what parents should be looking out for.
“The biggest symptoms of heart failure are shortness of breath, fatigue. A child just has no energy, they just lay there; they don’t want to do anything. Some of these patients also had very high fevers for more than five days, rash, strawberry tongue — which is a deep red tongue with white dots, it looks like the surface of a strawberry. Red, runny eyes, so conjunctivitis. All those things go with the Kawasaki-like syndrome. The problem is not all of these patients have all of the symptoms,” she said.
In New Jersey, there’ve been 12 pediatric hospitalizations related to the inflammatory disease and one child fatality, although Health Commissioner Judith Persichilli updated the press at Saturday’s briefing.
“Yesterday I reported the death of a 4 year-old with underlying conditions. We have no indication at this point in our investigation that the death was related to Kawasaki disease,” Persichilli said.
In New York, there were just 15 cases as of last Monday. A week later, that number has jumped to 93 and three kids have died, according to New York Gov. Andrew Cuomo.
But at Bristol-Myers Squibb Children’s Hospital, part of Robert Wood Johnson University Hospital in New Brunswick, the medical team is hopeful about the treatments.
“Patients who are presenting with this atypical Kawasaki disease do seem to be responding to the therapies we traditionally use for Kawasaki disease. So number one would be intravenous immunoglobulin, or IVIG, which is antibody therapy. Also steroids, and we have been using a lot of what are called immune modulators,” Owensby said.
Immune modulators shut down the body’s immune system so that it stops attacking the body long after the virus is gone. It can explain why symptoms start weeks after a child’s been exposed to COVID. But there is concern about the long-term impact of severe cases.
“We know with Kawasaki’s disease that long term their coronary arteries can develop aneurysms, which would put them at increased risk for stroke and for heart attack,” she said. “These patients are going to have to be followed long term.”
Owensby says it could be a matter of months to years that a stroke or heart attack could develop.
She urges any parent who’s concerned about their child’s health not to avoid taking them to their doctor.
“The concern always is that these patients are sick and they’re getting sicker and they’re staying home. So just be aware that hospitals, doctors offices have very strict, stringent measures in place so people do not get infected when they come to the emergency room,” she said.