In late April and early May, health officials in the United Kingdom and New York have found evidence of a pediatric multi-system inflammatory illness that may be linked to COVID-19. On Thursday, the Centers for Disease Control and Prevention released an alert to healthcare providers on the illness — dubbed MIS-C or “multisystem inflammatory syndrome in children” — which has symptoms similar to toxic shock syndrome or Kawasaki disease in patients under 21 years old.
“The Centers for Disease Control and Prevention (CDC) is providing 1) background information on several cases of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19); and 2) a case definition for this syndrome,” per the release via the CDC Health Alert Network. “CDC recommends healthcare providers report any patient who meets the case definition to local, state, and territorial health departments to enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome.
5/14: @CDCgov releases an advisory via Health Alert Network with a case definition for what is now described as Multisystem Inflammatory Syndrome in Children (MIS-C) https://t.co/c5unIpyf3u pic.twitter.com/9Fe6AlTgjX
— Jay B. Varkey (@jaybvarkey) May 15, 2020
The story of how providers were first alerted to the illness started in late April, per the CDC. Doctors began noticing that children who were “previously healthy” were coming down with symptoms of a Kawasaki-like disease — which means symptoms of high fevers that last for five or more days, rashes on the torso or groin, bloodshot eyes, red swollen lips, red hands and soles of feet and swelling in the lymph nodes, hands and feet, among others — after testing positive with a “current or recent infection by SARS-CoV-2 (the coronavirus that causes COVID-19).
“Eight cases, including one death, from the UK were described in a recent publication. In the limited sample of 8 children, it was reported that 75 percent of the patients were of Afro-Caribbean descent and 62.5 percent were male. The report also indicated that all eight patients tested positive for SARS-CoV-2 through antibody testing, including the patient that died,” the alert notes. “During March and April, cases of COVID-19 rapidly increased in New York City and New York State. In early May 2020, the New York City Department of Health and Mental Hygiene received reports of children with multisystem inflammatory syndrome. From April 16 through May 4, 2020, 15 patients aged two to fifteen years were hospitalized, many requiring admission to the intensive care unit. As of May 12, 2020, the New York State Department of Health identified 102 patients (including patients from New York City) with similar presentations, many of whom tested positive for SARS-CoV-2 infection by RT-PCR or serologic assay. New York State and New York City continue to receive additional reports of suspected cases.”
On Friday, May 8, New York State Governor Andrew Cuomo tweeted that the NYS Department of Health was monitoring 73 cases of the Kawasaki disease/toxic shock-like symptoms in the state and that a 5-year-old boy in New York City died from complications caused by this illness.
The CDC notes that as new information develops it is still unknown if the illness is “specific to children or if it also occurs in adults.”
“CDC is requesting healthcare providers report suspected cases to public health authorities to better characterize this newly recognized condition in the pediatric population.”