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Coronavirus 13.0

There have been 4 pediatric deaths from a new syndrome first reported last week. It’s being called Pediatric Multi Inflammatory Disorder. Always so tragic losing children. Three in NY and one in NJ. One of the deaths from Westchester county is being re-evaluated for other causes. It’s still not entirely clear if the syndrome is COVID related. Not all children with the syndrome have a history of COVID and the illness is occurring at a later point from when those who did have it were infected. It may be from the immune response to COVID but it’s really strange it would be that far out from date of onset or exposure. Some as long as 4-6 weeks later. At least one child that died had a significant medical history.

It resembles two syndromes we are familiar with. One is Kawasaki disease (KD), a more treatable and less dangerous version. We get 3,000 cases of KD a year in the US. The other is closer to the very serious Toxic Shock Syndrome (TSS) usually caused by a bacterial infection that releases toxins. Its the toxins, not the infection itself that lead to the multi system organ failure in TSS. It’s possible there is an outbreak of bacterial infections causing that particular presentation. If so it’s not related to COVID. KD is more known to follow viral illnesses but TSS is not. The CDC and other children’s hospitals are looking at it very carefully. There have been cases in other highly affected countries as well though always very rarely. Interestingly, in countries like Japan, China and South Korea they have no cases reported despite many COVID cases. We are fortunate to have CCMC’s terrific staff and facilities right here in Hartford. They are more than capable of caring for any child that may come down with it.

In addition, all cases so far are from areas with a very high disease burden so it’s possibly not causative but coincidence and caused by something else entirely.

It is still really uncommon but like anything new and potentially deadly it obviously bears careful watching, vigilance and early recognition. Most children have recovered. The statement that this is a new chapter in the COVID pandemic made by Mr. Cuomo is premature and hopefully inaccurate, though headline grabbing. He should be offset by the doctors plainly saying how rare it is. Medical information should not come from our politicians. I much prefer doctors but I am admittedly biased.

While alarming it’s not something to be terribly frightened of at this point because it is so rare. In CT, CCMC and Yale are dealing w 3 cases each. The CCMC children are cases being reassessed after the fact as they presented over the past 2 weeks. This means it’s possible they are not COVID related and simply cases of KD that we might have had anyway. From reports all children are doing well and responding to treatment. We will be watching more for it for sure but right now parents need to understand COVID is still a very mild disease in children and primarily effects older people. They need to remain calm while observing for any unusual symptoms. I have no doubt they will be that way. Unlike COVID, this syndrome is not subtle. The children affected are much more ill with high ever accompanied by a pale, sick appearance, rash, dry cracked lips, sometimes conjunctivitis and swollen lymph nodes. Fever seems to be the most consistent feature.

We are all fatigued by word the last 2-3 months. The uncertainty of it all tremendously anxiety promoting. Let’s hope and pray this is not going to become another part of the nightmare.