As the COVID-19 pandemic has progressed, many parents have found solace in the fact that, generally, children do not suffer as severely from the virus as adults do. While children can contract and transmit the virus, the majority tend to experience mild symptoms or none at all, and hospitalizations are uncommon. However, the emergence of a new inflammatory condition linked to COVID-19 has raised concerns.
Recently identified as “pediatric multisystem inflammatory syndrome” (PMIS), this condition first appeared in Europe and has since been reported in New York state, with around 100 cases documented, and additional cases in 14 other states. Tragically, three children in New York have succumbed to this syndrome, heightening worries among parents.
This condition manifests through inflammatory symptoms in children, including fever, rash, swollen lymph nodes, abdominal pain, and cardiac issues. Notably, many affected children have tested positive for COVID-19 or its antibodies. According to a memo from the New York State Department of Health dated May 6, 2020, “the majority of patients with this syndrome have tested positive for SARS-COV-2 or corresponding antibodies.” Some children tested positive via molecular diagnostics, while others showed antibodies through serological testing.
Experts draw parallels between PMIS and Kawasaki disease, along with toxic shock syndrome. However, Dr. Laura Cohen, a pediatric disease specialist at Westside Children’s Hospital, emphasizes that these conditions are not identical. “At this stage, it appears that PMIS is distinct from Kawasaki disease and its shock syndrome,” Dr. Cohen clarifies. She notes that while there are overlapping symptoms—such as conjunctivitis, rash, and red lips—the new syndrome presents unique characteristics, including systemic hyperinflammation, multi-organ involvement, and severe abdominal symptoms, which are not typical of Kawasaki disease.
The clinical presentation of PMIS in children resembles the later stages of COVID-19 in adults, characterized by vasculitis, cytokine storms, and multi-organ injury. Dr. Cohen elaborates, “The symptoms these children exhibit mirror those seen in adults during severe COVID-19, including myocarditis, diarrhea, and acute kidney injury.”
A pressing question remains: why has this inflammatory syndrome emerged in children only now, several months into the pandemic? Dr. Cohen highlights ongoing research efforts to unravel this mystery. Some children are found to have active COVID-19 infections, suggesting a possible link between the virus and the cytokine storm that triggers PMIS. Yet others, who present with antibodies rather than active infections, indicate that the syndrome may arise 10-14 days post-infection, possibly due to an immune enhancement mechanism.
So, how should parents navigate this troubling development? Dr. Cohen reassures parents that while this new syndrome is concerning, the overall incidence of COVID-19 in children remains low, with adults accounting for 98% of cases. “It’s crucial for parents to stay vigilant, but not to panic. Contact your pediatrician if your child shows any unusual symptoms, such as fever or rash,” she advises.
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In summary, while the pediatric multisystem inflammatory syndrome poses new challenges amid the COVID-19 pandemic, continued research and awareness can empower parents to respond effectively and keep their children safe.