Novel childhood COVID-19 illness - early detection is the key!
Dr. Akshat Jain is a pediatrician practicing in Southern California. Dr. Jain is a doctor who specializes in the health care of children and adolescents with a specialization in pediatric blood and cancer diagnoses. As a pediatrician, Dr. Jain diagnoses and treats infections, injuries, diseases, and other disorders in children.... more
The recent pandemic has confined people all over the world to the indoors to try to keep the virus from spreading. Older adults have been the most commonly affected age group with the virus but more recently a strange presentation of COVID-19 has been seen in children.
New York City, first reported 15 similar cases that occurred between April 16 and May 4 for the first time in the United States. New York State health officials were investigating 102 cases as of May 12. Multiple reports thereafter from overseas and other states of the US ensued that reported similar symptoms and presentations in children who were also were testing positive for COVID-19.
It mirrors the presentation of a dramatic disease of children called Kawasaki Disease, wherein the body goes into an overdrive leading to overactivation of inflammation. This new disease has been given a name - Multisystem inflammatory syndrome in children (MIS-C) and the CDC recently issued guidance to diagnose children with MISC if they have -
- Age <21 yrs with fever, laboratory evidence of inflammation and evidence of clinically severe illness requiring hospitalization with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); and
- No alternative plausible diagnoses; and
- Positive for current or recent SARS-CoV-2 infection by a reverse-transcriptase polymerase chain reaction, serology or antigen test; or COVID-19 exposure within the four weeks prior to the onset of symptoms.
Simply put if a child develops high-grade fever (38 degrees C or 100.4 degrees F or higher for children), fever, a rash, swollen hands and feet, red eyes, swollen lymph nodes and red, swollen or cracked lips, mouth, throat, and tongue, etc., immediate help with the pediatrician/family doctor should be sought. This identifies the cases earlier as prompt and early treatment leads to full recovery in children in most cases and delay on the other hand can lead to life-threatening cardiac complications. Treatment with medications called Immunoglobulins and supportive care in a hospital setting is needed.
A special population of children with chronic diseases like Type 1 Diabetes, Sickle Cell Anemia, Pediatric Cancer, and other blood disorders are immunocompromised and are furthermore at risk for COVID infection and its effects. Special precautions with social distancing measures and hand hygiene are needed around such patients, more than ever. Always consult your primary care doctor and specialist for the latest guidance and management strategies that are constantly evolving as more information comes in.
- Do not avoid getting your child checked if they are demonstrating any of these symptoms.
- Vaccination saves lives and now more than ever, do not skip the visits to your pediatrician and make sure your child is fully immunized.
Akshat Jain M.D., M.P.H.
Faculty Department of Pediatrics & Clinical Medicine
Pediatric Hematology-Oncology and Stem Cell Transplantation
Loma Linda University School of Medicine & Loma Linda University Children's Hospital
Assistant Professor of Public Health, Loma Linda School of Public Health
