(CNN) – Parents, hospitals and clinics should expect to see more cases of a perplexing condition that appears to be affecting children after they recover from covid-19, doctors said Wednesday.
The condition, called multisystemic inflammatory syndrome in children, appears to be a postviral syndrome, said Dr. Jeffrey Burns, a critical care specialist at Boston Children’s Hospital who has been coordinating a global group of doctors comparing notes on the condition.
Doctors are investigating cases in at least 150 children, most of them in New York. But a CNN poll reveals that hospitals and clinics in at least 17 states and Washington DC are investigating suspected cases.
“This multi-system inflammatory syndrome is not directly caused by the virus,” Burns told CNN. “The main hypothesis is that it is due to the patient’s immune response.”
Symptoms include persistent fever, inflammation, and poor function in organs such as the kidneys or the heart. Children may also show evidence of inflammation of the blood vessels, such as red eyes, a bright red tongue and chapped lips, said Dr. Moshe Arditi, an expert in pediatric infectious diseases at Cedars-Sinai Medical Center in Los Angeles.
Dr. Ngozi Ezike, director of the Illinois Department of Public Health, said it is a complicated disorder.
“It is a spectrum of disorders, so in some cases, it will cause the person to have coronary artery involvement. Sometimes not, ”Ezike said at a press conference.
A late response to infection
Not all affected children have tested positive for coronavirus, but reports from Europe and several cities in the United States show a link.
“There appear to be late responses to covid infections in these children,” said Arditi.
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Burns believes that more cases will appear as covid-19 affects more people. It is a rare condition, but the rare consequences of viral infections are seen most often when millions of people are infected.
“We can expect each of the epicenters to see clusters of these emerge approximately four to six weeks later,” Burns told CNN.
“It makes sense that it arose in New York first because New York had the largest and most severe (covid-19) outbreak, followed by New Jersey and, unfortunately, Boston,” he added.
Most children are not seriously affected by the syndrome, Burns said. Most don’t even need treatment in the intensive care unit, he said, although very few have died. “We have proven treatments that we can use and are using,” he said. They include anticoagulants and immunomodulators.
The Centers for Disease Control and Prevention are preparing a notification from the Health Alert Network to send to doctors across the country, a CDC spokesman said. Burns said the World Health Organization is also working to define the syndrome and alert doctors to know what to look for and how to treat it.
“This new disease has some similarities to Kawasaki disease,” Arditi told CNN. “But there are many more characteristics that are consistent with toxic shock syndrome, such as involvement of the multiorgan system and severe abdominal involvement with diarrhea,” he added.
It will be important to study it, because the answer could help explain why children are much less likely to be severely affected by covid-19 than adults, Burns said.
“Understanding the child’s immune response could be key to vaccine development and could also be key to therapy so that adults understand why children can fight so well (against covid-19),” Burns said.
Doctors find suspicious cases in 17 states
CNN has reached out to health departments, hospitals, and state officials across the country to get an idea of how many children are affected and where.
Some state health departments told CNN they are waiting for the CDC alert. “We are working with the CDC on defining a case and are looking for possible cases, but we will not have more until the CDC finalizes its definition,” said a spokesman for the Minnesota Department of Health.
“We don’t think this syndrome is very common, but several cases have been reported elsewhere in association with covid-19,” said Dr. Paul Cieslak, medical director for infectious diseases and immunizations in the Division of Public Health at the Oregon Health Authority. “This syndrome appears to be a rare but serious complication of covid-19 in children.”
Connecticut Governor Paul Mounds said the syndrome would be a traceable disease in the state. The Department of Public Health “sent this to all Connecticut pediatric health systems to make sure they are reporting if these cases are occurring on their premises so that we can track and manage it accordingly,” Mounds said Wednesday.
States that report cases include:
California
Delaware
Illinois
Kentucky
Louisiana
Massachusetts
Michigan
Minnesota
Missouri
New Jersey
NY
Ohio
Oregon
Pennsylvania
Tennessee
Utah
Washington
Rebekah Riess, Gisele Crespo and Amanda Watts of CNN contributed to this report.
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