‘Even the name is vague’: Cleveland Clinic doctor answers questions on ‘uncommon’ mystery illness linked to COVID-19 in children

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CLEVELAND, Ohio (WJW) — As the coronavirus pandemic has unfolded here in the United States, we’ve heard a lot about cases and deaths mostly involving adults.

But in recent weeks, we’re learning more and more about a condition linked to COVID-19 that is affecting children: pediatric multisystem inflammatory syndrome.

“Of the two or three months of this pandemic, we’ve focused on the adults,” said Dr. Frank Esper, pediatric disease specialist at Cleveland Clinic Children’s. “They’re the ones who have really gotten sick. And we’re now only seeing what’s going on in children.”

**For a complete interview with Esper, watch the video at the bottom of this page**

Who does it affect?

It mostly impacts children who have tested positive for the virus or antibodies and reportedly resembles Kawasaki disease or toxic shock syndrome. Scientists first spotted it in children with COVID-19 in Europe.

Several cases have been reported across the country. It’s being blamed for at least three deaths in New York.

But Esper emphasized that the condition is “uncommon, if not rare.”

“Even with this whole coronavirus and anticipated hundreds of thousands of children infected, we’re only seeing a few dozen or hundreds, tops, of this syndrome,” he said. “We’ll have a lot more information in the weeks to come.”

Esper said the condition happens mostly in children between the ages of two to eight and in adolescents up to the age of 21. The children aren’t testing positive for COVID-19, but it seems to happen after a child recovers from the virus and “the immune response gets a little out of whack.”

“The immune system gets ramped up and can’t ramp itself back down,” he said.

Esper said most children who get the condition don’t have any preexisting or underlying conditions. It does occur more often in males than females he said, “but most of the time it does not discriminate.”

Some older adults who have had COVID-19 have also had inflammatory problems. But pediatric multisystem inflammatory syndrome seems to be different or a pediatric variant, he said.

How does it present?

Esper said the syndrome most usually starts off with a high fever or a rash. The child may have bloodshot eyes and even red lips. They’re extremely fatigued, and when evaluated, can have breathing or heart problems.

The condition in some cases leads to heart, lung or kidney problems.

How is it treated?

Treatment is mostly supportive care, he said.

“We’re not trying to treat the virus,” he said. “It may have triggered this, but it’s not causing it. The virus has come and gone in most of these children. We attack the inflammation and try to get it under control. Sometimes that happens on its own.”

If children need help with their lungs, they may be given medicine or oxygen. If their heart needs help, they’ll be given support for that. If nothing works, there is a medication doctors will use to “attack the inflammation.”

Esper emphasized that “a lot of kids do get better.”

Learning more

It will likely take more time to understand how it’s happening or why.

“This is something we have only recently recognized in the last several weeks,” said Esper. “Even the name is vague if you think about it. It just means something that inflames a lot of things at the same time.”

“We’re still learning a lot about this disease,” he said. “And we will probably know a lot more as the weeks go on.”

While medical experts say the condition is “rare,” they advise families that have had a coronavirus infection be on the lookout for the following symptoms:

  • Prolonged fever (more than five days)
  • Difficulty feeding (infants) or is too sick to drink fluids
  • Severe abdominal pain, diarrhea or vomiting
  • Rash or change in skin color – becoming pale, patchy and/or blue
  • Trouble breathing or is breathing very quickly
  • Racing heart or chest pain
  • Decreased amount of frequency in urine
  • Lethargy, irritability or confusion

Click here for more on pediatric multisystem inflammatory syndrome.

More coronavirus coverage, here.

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