US - Inflammatory response in children possibly due to COVID-19 - Media documents at least 85 cases

[kiwibird]

https://www.foxnews.com/health/15-ch...navirus-report

Hospitals in New York City have reported that they are treating 15 children that have shown symptoms often associated with Kawasaki disease, which global health officials have linked to the coronavirus.

...

The New York Times reported early Tuesday that the children range from 2 to 15. Their illnesses have been described in a bulletin as a multisystem inflammatory syndrome potentially linked to COVID-19.

Last week, Matt Hancock, the U.K.’s health secretary, issued a warning that some children have died in Italy and Britain from an unknown condition that has been likened to Kawasaki disease. Doctors in Europe said some of the children who died from the inflammatory ailment had no underlying conditions.

The Times pointed out that none of the children in the U.S. died.

 

[sharon sanders]

hat tip Michael Coston for link


NYC alert related to above article on this: https://www1.nyc.gov/assets/doh/down...y-syndrome.pdf

 

[kiwibird]

https://antiguaobserver.com/internat...g-coronavirus/

By New York Post

An 8-year-old Queens boy with no underlying medical conditions was diagnosed with COVID-19, put on a ventilator and suffered heart failure after initially coming down with a bout of diarrhea, according to a report.

Jayden Hardowar, of Richmond Hill, developed a fever and suffered from diarrhea in late April, so his parents took him to his pediatrician, according to WNBC.

His mom, Navita, said Jayden, who never showed any shortness of breath, took Tylenol and that his fever broke after a few days — but his dad, Roup, said the boy’s strength hadn’t come back.

“His body strength started to go down, he started to become a little bit weak,” Roup, a Con Ed worker, told the news outlet. “We followed up with his pediatrician, and they thought that he would come around, maybe because he wasn’t eating a lot.”

But on April 29, Navita became alarmed when Jayden called for her from his bed.

“I heard him call for Mommy. Jayden has a strong voice when he calls for Mommy, (but) his voice was very low,” she said. “That voice grabbed my attention.”

Navita said she noticed that Jayden’s head and hands were twisted in awkward positions.

“I quickly looked over at his face and his lips were all blue at that point, so right away I knew something was not right here with Jayden,” Navita said, adding that her son did not respond when she called out his name.

Struggling to find a pulse, Jayden’s dad and Boy Scout brother Tyrone, 15, began performing CPR as Navita called 911. An ambulance soon rushed Jayden to Jamaica Hospital.

 

[Emily]

Theory here about why this virus might tend to cause allergenic or delayed hypersensitivity reactions and a concern that vaccines should be constructed to avoid this (Entry #2 Feb 2):

http://virological.org/t/response-to-ncov2019-against-backdrop-of-endogenous-retroviruses/396

 

[kiwibird]

https://uk.reuters.com/article/us-he...-idUKKBN21O2XE

NEW YORK (Reuters) - Up to 20% of U.S. children infected by the novel coronavirus require hospitalization, with infants under age 1 most likely to be in that group, according to the government’s first in-depth analysis of the disease in the youngest patient population.
...
Up to 2% of infected children required intensive care unit admission, the analysis found.

 

[kiwibird]

https://www.reuters.com/article/us-h...source=twitter

CHICAGO (Reuters) - U.S. scientists are working to understand a rare, life-threatening inflammatory syndrome in children associated with exposure to the new coronavirus by quickly assembling clinical trials and patient registries.
....
Cases were first reported in Britain, Italy and Spain, but now doctors in the United States are seeing clusters of kids with the disorder, which can attack multiple organs, impair heart function and weaken heart arteries.

This emerging syndrome, which may occur days to weeks after a COVID-19 illness, reflects the surprising ways that this entirely new coronavirus infects and sickens its human hosts.

At least one child in Britain has died. No children are believed to have died so far in the United States, “but that could change,” said Dr. Sean O’Leary, a pediatric infectious disease expert at Children’s Hospital Colorado who serves on the American Academy of Pediatrics committee on infectious disease.

...snip
Emphasis mine.

 

[Emily]

"CDC researchers emphasize the findings are still based on incomplete data, as most cases lacked information on disease symptoms, severity or patients’ underlying conditions. "

Also "up to" is anything from <.1 to 20% or <.1 to 2% in the second case. Not very helpful in assessing risk, CDC.

 

[Emily]

https://www.kiro7.com/news/local/se...rome-linked-covid/KEV36F4MPRDFNHSXGGACWMZTM4/

Seattle Children’s has one patient with inflammatory syndrome linked to COVID

...
Portman said the patient is stable after shock-like symptoms sent him to the intensive care unit.

The patient had a high fever.

“We’ve had a definite drop in the number of patients appearing for admission at Seattle Children’s for Kawasaki Disease, and we believe that may be because parents are afraid to bring their children to the emergency room and risk exposure (to COVID-19),” Portman said...

If fear of what is a mild infection for most kids is keeping kids with a disease that really needs treatment away from care, our public health messaging is amiss. Hope we actually have a drop in the syndrome for some reason. Seattle has had a much less severe outbreak of COVID than New York.

 

[sharon sanders]

At least 85 kids across U.S. have developed rare, mysterious COVID-19-linked illness

While severe cases of the coronavirus have largely spared children, evidence is growing that kids may not be as immune to COVID-19 complications as previously thought.

snip

NBC News has found at least 85 such cases in children across the U.S. The majority — 64 — are in New York state, which has also recorded the highest number of COVID-19 cases overall.

https://www.nbcnews.com/health/healt...rious-n1202186

 

[kiwibird]

https://www.aljazeera.com/news/2020/...190633808.html

'Every parent’s nightmare': NY boy's death may have virus link


At least 73 children in New York have been diagnosed with symptoms similar to Kawasaki disease.

A five-year-old boy has died of a rare inflammatory condition possibly linked to COVID-19, the first such death in New York, Governor Andrew Cuomo said Friday.

While children have been shown, so far, to be far less likely to suffer severe harm from the coronavirus, there is growing concern that a rare complication might be causing some to experience swollen blood vessels and heart problems.
....snip

 

[kiwibird]

A small study of 50 children from Wuhan. I understand the main conclusion is that there should be different discharge criteria for children. This would seem appropriate as in one of the above articles it stated that children could succumb to Covid 19 some weeks after appearing to recover.
https://flutrackers.com/forum/forum/...-investigation :tiphat:Tetano https://rdcu.be/b33jK

A Paediatric study

Lesions in most of the 15 patients (67%) who received chest CT at discharge were not completely absorbed, and 26% of these pediatric patients had CT lesions that were either unchanged or worse.
...
The results are consistent with the knowledge that clinical improvement predates radiographic improvement by weeks for children with community-acquired pneumonia.
...

These results oppose current COVID-19 hospital discharge criteria in China, as one requirement is that pulmonary imaging must show significant lesion absorption prior to discharge. These differences between pediatric and adult cases of COVID-19 may necessitate pediatric-specific discharge criteria.

 

[Emily]

Kiwi, are you thinking that unresolved COVID (or secondary bacteria infection) disease might be causing the rare inflammatory syndrome, along the lines of theories about PANDAS and chronic lyme? Maybe something other than a CT could be used to investigate that, since they try to avoid radiation exposure as much as possible with children. Hopefully resolution is more complete now. Usually novel viruses start to weaken as time goes by.

Our study had a few limitations. First, this study has a small sample size and was conducted at a single-center in Wuhan, China, located at the center of the outbreak. The clinical severity of pediatric patients outside Wuhan may be less severe. Indeed, it is reported that there is a lower death rate of adult patients outside Wuhan areas. Second, long-term follow-up was not done because of the short time for data collection.

 

[kiwibird]

Yes - there was one small toddler who was the first child I saw - very early on in Wuhan - and his parents had taken him to hospital. He had appeared to recover and then, three or so days later, he became very ill very quickly and sadly died. It seems obvious that children should be monitored for much longer than thought after "recovery". I wonder if oxygen saturation levels would indicate something going on? Heart rate??? Perhaps this is similar to the swine flu where very active children, even young athletes, were resuming activity after the flu and then being overwhelmed and suffering cardiac arrest.

They tend to keep going, children, even though they feel tired - and the thinking then was that they should check (or have checked) their heart rate and if it was 10 beats per minute above their normal resting heart rate - that they should rest.

We definitely need more information.
Links to past discussions regarding children and flu
https://flutrackers.com/forum/forum...h-pandemic-h1n1-influenza-a-virus-in-children

https://flutrackers.com/forum/forum...-kids-succumbed-to-swine-flu-death-audit-pune

https://flutrackers.com/forum/forum...influenza/82360-h1n1-flu-can-attack-the-heart

https://flutrackers.com/forum/forum...-sudden-deaths-and-influenza/page2#post546260

 

[kiwibird]

Kiwi, are you thinking that unresolved COVID (or secondary bacteria infection) disease might be causing the rare inflammatory syndrome, along the lines of theories about PANDAS and chronic lyme? Maybe something other than a CT could be used to investigate that, since they try to avoid radiation exposure as much as possible with children. Hopefully resolution is more complete now. Usually novel viruses start to weaken as time goes by.

https://www.ncbi.nlm.nih.gov/pubmed/10816149

Abstract


An outbreak of severe pneumococcal pneumonia among children occurred in Iowa from November 1995 through January 1996. An associated outbreak of influenza disease was predominantly caused by influenza A (H1N1) for the first time since 1989. We conducted a case-control study to determine whether preceding influenza infection was directly associated with pneumococcal illness. We identified 13 children with severe pneumococcal pneumonia

Patients were more likely than control subjects to report experiencing an influenza-like illness in the 7-28 days preceding admission (matched odds ratio [OR], 12.4; 95% confidence interval [CI], 1.7-306). Likewise, family members of patients were more likely than those of control subjects to report experiencing an influenza-like illness in the 28 days preceding their admission date (OR, 2.6; 95% CI, 1.0-6. 3)

. ...snip

and further it is worth repeating Tetanos comprehensive list - https://flutrackers.com/forum/forum/...ge2#post546260

 

[Emily]

Thank you, Kiwibird. Checking oxygen and pulse are certainly non-invasive and I read about a UK doctor that did that or had it done. https://multiple-sclerosis-research.org/2020/05/mscovid19-frontline/
He had symptoms but is over 60 yrs old. Maybe a child wouldn't have a fever. The Kawasaki syndrome on the other hand might be harder to catch until there are symptoms. It seems more like an autoimmune reaction, but I don't know if anyone completely understands it. Since they call it atypical, maybe in this case it is infective rather than post-infective. I read that COVID virus experimentally can directly infect lab grown human blood vessels. https://www.sciencedirect.com/science/article/pii/S0092867420303998 So is infection cleared in these cases?

 

[kiwibird]

Super interesting articles Emily. Thank you.