Question: What’s the story with the new COVID-related syndrome in kids that I’ve started hearing about… Kawasaki?
Answer: There’s always another layer of this onion. A few weeks back, doctors in the UK reported seeing a small number of children (8 children) who had been infected with SARS-CoV-2 presenting with a “significant systemic inflammatory response” that was similar to Kawasaki disease (described below). None of these children had previously been symptomatic. Since then, researchers in Italy found a 30-fold increased incidence of Kawasaki-like disease — 10 children presented in 1 month in Bergamo province. And as of May 12, the New York State Department of Health had identified 102 patients presenting with Kawasaki-like conditions.
As a result of these findings, CDC issued a Health Advisory yesterday that describes case criteria of this “multisystem inflammatory syndrome” and requests “healthcare providers report suspected cases to public health authorities to better characterize this newly recognized condition in the pediatric population.” CDC’s Advisory also notes: “It is currently unknown if multisystem inflammatory syndrome is specific to children or if it also occurs in adults. There is limited information currently available about risk factors, pathogenesis, clinical course, and treatment for MIS-C.” In all of these instances, the number of children affected is quite small as a proportion of the whole. Nonetheless, these findings are clearly concerning. Silver lining is that knowledge of this condition is becoming more widespread, which means that the medical community can more quickly identify patients and appropriately respond.
*Kawasaki disease is quite rare — it is an acute illness accompanied by “fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands in the neck, and irritation and inflammation of the mouth, lips, and throat.” It’s of unknown cause and primarily affects children <5 years of age. Kawasaki is a leading cause of acquired heart disease in the United States. It’s symptoms can be confused with those of toxic shock syndrome.