New global trend of COVID-19 linked disease in children

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At the direction of Governor Cuomo, the State Department of Health has issued an advisory about this serious inflammatory disease, called "Pediatric Multi-System Inflammatory Syndrome Associated with COVID-19", to inform healthcare providers of the condition, as well as to provide guidance for testing and reporting.

Here's what we know so far about the symptoms of multisystem inflammatory syndrome in children, including the latest guidelines from the CDC to protect kids.

"The symptoms in children are different from adults with COVID-19 in whom the illness is more of a respiratory condition", said Dr George Ofori-Amanfo, division chief of Pediatric Critical Care at Mount Sinai Kravis Children's Hospital in NY.

Dr. Kristina Bryant says this syndrome presents symptoms resembling Kawasaki Disease and Toxic Shock Syndrome.

Doctors in Bergamo, northern Italy reported a 30-fold increase in the incidence of severe inflammatory disorders among young children, with ten cases from mid-February to mid-April as compared to 19 during the previous five years, according to a study this week in The Lancet.

He said the New York State and Department of Health were at the forefront in the USA in investigating the illness.

The trend was not limited to the United Kingdom and Italy, with the US, France, Spain and Switzerland all also having reported cases.

The 5-year-old boy passed away in New York City from these COVID-19 related complications. The inflammatory syndrome has features which overlap with Kawasaki disease and toxic shock syndrome and may occur days to weeks after acute COVID-19 illness.

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Your child's doctor will refer him to a "specialist in pediatric infectious disease, rheumatology, and/or critical care", says Dr. Daskalakis.

"If you look at the curves, COVID-19 has plateaued, but there's an exponential rise in this secondary type of shock syndrome", says cardiologist Jane Newburger, MD, MPH, an global expert on Kawasaki disease who was also on the May 2 panel.

"There's still some work to be done in establishing exactly what the link is between COVID-19 and this inflammatory disease", she said.

Children with PMIS start with a persistent fever over 100.4 degrees and have another symptom of inflammation: it could be swollen lymph nodes, bright red lips and tongue, pink eyes, or swollen extremities. Three children are said to have died of the syndrome there.

Health Secretary Matt Hancock said experts were investigating the trend with "great urgency", but said it was rare. Almost 33% of the children were still hospitalized due to COVID-19 at the end of the follow up period, with 3 still requiring ventilator support and 1 on life support; and 2 of the children admitted during the 3 week study period lost their battle with this disease.

"The good news is that, like Kawasaki disease, nearly all the kids are treatable", he added. Only 2.1% of all laboratory-confirmed COVID-19 cases reported to The European Surveillance System (TESSy) were in the age group between 0 and 14 years of age.

Dr. Hanna said the timing of this outbreak was "suspicious".

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