Doctors in the St. Louis area are monitoring at least four cases of a rare childhood illness linked to COVID-19.
The emergence of the sickness known as multisystem inflammatory syndrome means children may not be as safe from the coronavirus as public health experts initially thought, doctors said.
“I think we were operating under the assumption that kids got a free pass, to some degree, and that was reassuring,” said Dr. Bradley Ornstein, a pediatric infectious disease expert at Mercy Hospital St. Louis. “A little bit of that has been lost at this point in my mind.”
Across the country, children in areas with high numbers of COVID-19 cases have been hospitalized after their immune system started attacking itself. Symptoms include a high, sustained fever, red eyes and rashes. In the most serious cases, the disease can lead to inflammation of blood vessels.
While children who contract the coronavirus still are likely to have a mild case of COVID-19 or no symptoms at all, many coming to the hospital with the new syndrome test positive for the virus or are shown to have produced coronavirus antibodies, which means they had at one point been infected even if they didn’t know it, doctors said.
Hospital officials would not give exact patient counts but said there are “a handful” of children with the syndrome being treated at SSM Health Cardinal Glennon Children's Hospital and St. Louis Children’s Hospital. Public health officials confirmed another case in St. Clair County over the weekend.
The inflammatory illness shares characteristics of Kawasaki disease, another rare inflammatory illness, Ornstein said. It usually shows up after children recover from viruses or other illnesses, he said.
“Something bizarre happens to your immune system, and it just triggers into overdrive,” he said. “After the fact, their immune system for some reason gets turned on and starts going a little rampant, causing these very interesting symptoms.”
Doctors haven’t found if the coronavirus is directly causing the problem, Orstein said.
“It’s been a challenge, I think, with all things COVID,” he said. “No one really knows what the answer is, and it’s going to be an evolving thing as we gather more data and see more cases.”
Eventually it could offer clues into how the immune system interacts with the coronavirus, he said.
The inflammatory syndrome and serious cases of COVID-19 are both rare in children, doctors said. Children make up a small portion of total hospitalizations related to the coronavirus.
“Like the other symptoms of COVID that we’ve been seeing in children, this syndrome is also extremely rare,” said Dr. Rachel Charney, a pediatric emergency medicine physician and medical director of disaster preparedness at SSM Health Cardinal Glennon Hospital.
“So far the overall prevalence of both this syndrome and what we’d normally define as COVID in children is still quite rare when we compare it to the adult population,” she said.
It should serve as a reminder for parents to continue to take safety precautions such as social distancing seriously, Charney said.
Parents should be on the lookout for a high fever in children and should talk to a doctor if it lasts more than a few days, doctors said.
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