Multisystem inflammatory syndrome in children (MIS-C and COVID-19)

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My final assessment after posts above indicate that IMO, as a result of MASSIVE family travel and gatherings over Thanksgiving, as well as an already severely escalated Covid situation, there is very likely IMO going to be a surge of children, and babies, who will get very ill, have potential long term effects, and some (more) will die. Again, this is not something we are seeing a lot of talk about (yet), but wait for it, imo. This is very upsetting, especially considering much will occur due to disinformation and outright disregard, which could have been prevented.

Yesterday I mentioned the guilt that some may later feel for infecting their family members as a result of Thanksgiving travel - well, I now revise this to include guilt over their children who, as seen above, could become sick and die as a result - “rare” or not. Again, what does one consider “rare” - there comes a point where even a small percentage results in a large number when there is this much community spread. IMO, with increasing cases, this will become “not as rare” as previously described, simply due to increased spread/prevalence, jmo.

It must also be noted that there are also documented cases of Post-Covid inflammatory syndromes appearing in adults, similar to MIS-C.

Yeah, I’m pretty upset about my friend exposing all his kids (discussed in main thread).

There are so many health workers sleeping in their basements and cars so they don’t expose their families. I’ve heard health workers after health workers say their biggest fear is bringing it home to their children.

More people are going to learn a very hard, truth after Thanksgiving. Sadly some of their kids, (or someone’s else’s children), whether it’s one, one hundred, one thousand, will pay this price.

(I’ve refrained from commentary so far, but had to weigh in after 7 pages.)
 
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Nov 30, covid-19 research and policy briefing

Mon November 30, 2020
RESEARCH BRIEFING
An Inflammatory Truth About Kids Getting Sick With Covid-19. MIS-C Rates By Race

More at link
Racial disparities in healthcare influence children's health across the board. Covid-19 is no exception. As we recently covered, Black children were found to be less likelyto be tested for covid-19 but were significantly more likely to have positive results. A new article in JAMA Network Open adds another blemish to the record of our country's inability to address structural racism as a persistent and pervasive plague in society. This time it concerns a rare but dangerous complication of covid-19 known as Multisystem Inflammatory Syndrome in Children, or MIS-C.

The latest research comes from the New York City Department of Health and Mental Hygiene's Incident Command System Surveillance and Epidemiology Section, and it describes the rates of this rare but potentially fatal later complication of coronavirus infection among children.

Epidemiologists focused on persons ages 0 to 19 years in New York City from March 1st to June 30th 2020 (though they collected data for persons up to age 21). Since MIS-C is a new and rare condition, finding children with this important covid-19 complication meant carefully scrutinizing medical charts for information related to inflammation. To that end, the New York State Department of Health issued guidelines on diagnosing MIS-C which included: persistent fever for four or more days, incomplete or complete signs of Kawasaki's Disease (a related condition, also often seen after viral infections in a small subset of children, though its causes are also unknown), and/or a "shock-like" presentation—meaning that the children are ill enough that they are not maintaining an adequate blood pressure, which in-and-of-itself can be life threatening. Once the researchers identified as many suspected MIS-C cases as they could, they then did something simple: they tabulated the numbers of children of various races and ethnicities and who had developed MIS-C.

In their search, 218 individuals ages 0-19 met the criteria for MIS-C. For those who met the diagnostic criteria, 82.5 percent of the medical charts had data on race and ethnicity. New York City is one of the most racially and ethnically diverse cities in the world and this paper lays that out explicitly: among the children whose records were studied, 36 percent were Hispanic, 26 percent White, 22 percent Black and 13 percent Asian or Pacific Islanders (other groups weren't covered in this analysis).

If we lived in a society where disease affected everyone equally, we would expect to see most of the cases of MIS-C in Hispanic and White children, based on the demographic data above. Alas, we do not. Black children bore a disproportionate brunt of MIS-C diagnoses, accounting for over 34 percent of the cases, despite accounting for 22 percent of the city's population. White children were underrepresented in the MIS-C sample, accounting for slightly under 13 percent of the MIS-C diagnoses.
 
CDC / COVID-19 and Your Health /People with Certain Medical Conditions
Updated Dec. 1, 2020

“While children have been less affected by COVID-19 compared to adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. Children with underlying medical conditions are at increased risk for severe illness compared to children without underlying medical conditions. Current evidence on which underlying medical conditions in children are associated with increased risk is limited. Children with the following conditions might be at increased risk for severe illness: obesity, medical complexity, severe genetic disorders, severe neurologic disorders, inherited metabolic disorders, sickle cell disease, congenital (since birth) heart disease, diabetes, chronic kidney disease, asthma and other chronic lung disease, and immunosuppression due to malignancy or immune-weakening medications.

We do not yet know who is at increased risk for developing the rare but serious complication associated with COVID-19 in children called Multisystem Inflammatory Syndrome in Children (MIS-C), nor do we know what causes MIS-C. Learn about MIS-C.”
 
Courtesy via @dixiegirl1035

Race and Ethnicity Among Children With COVID-19-Associated Multisystem Inflammatory Syndrome (MIS-C)
 
“A massive surge in coronavirus cases across the state has led to record numbers of infections, hospitalizations and deaths. And while health experts have yet to unlock the direct connection between the virus and MIS-C, what’s clear is that a spike in coronavirus infections is directly linked to an uptick in MIS-C cases, doctors told The Times.

“With the number of cases we’re seeing in Los Angeles now, I do expect to see more children with MIS-C coming into the hospital in the next few weeks,” said Dr. Jackie Szmuszkovicz, pediatric cardiologist at Children’s Hospital Los Angeles. “We’re at a critical moment right now.””

First child in L.A. County dies from COVID-19-related MIS-C
 
* I wonder if MIS-C data is being lumped in with general Covid numbers, as described in previous posts.

First LA County Child Dies From Coronavirus-Linked MIS-C

“At least 43 children have been treated for MIS-C in L.A. County, nearly 50% of whom were treated in intensive care units, according to the health department.

Of the children diagnosed with the syndrome, 26% were under the age of 5, 29% were between the ages of 5 and 11 and 37% were between the ages of 12 and 20. Latinx children account for 72% of the reported cases. None of the 43 children diagnosed with MIS-C in L.A. County have died.”

—

1st child in L.A. County dies from rare inflammatory syndrome linked to coronavirus | KTLA

“At least 145 cases of MIS-C have been reported among children in California, according to the state’s Department of Public Health. The Los Angeles County death appears to be the first in California, although no deaths linked to the illness have been recorded on the state’s database. Two children between the ages of 5 and 17 have died from COVID-19, data show.“
 
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First kid in SIPH District diagnosed with MIS-C, sent to Primary Children's - Local News 8
December 9, 2020

“But it was Covid. Cooper is among the 1,571 children in Southeast Idaho who have tested positive for coronavirus, but is the only one to be diagnosed with MIS-C, according to public health officials.”

[...]

“When treatment for Cooper's appendix didn't work, doctors rushed him to Salt Lake City.

BBM:
“When we got to Primary Children’s, he was not just having an appendix problem, his life was truly on the line,” Kale said.“

[...]

“Cooper is also participating in a 5-year study, called MUSIC, or Long-Term Outcomes after the Multisystem Inflammatory Syndrome In Children. He'll be among 600 other young people with MIS-C in the U.S. and Canada, participating in a research study to learn more about the syndrome and it's long-term health effects on children.“
 
Derm Symptoms Signal MIS-C in Kids
— Case series shows mucocutaneous findings in most children
Dec. 9, 2020

“Among 35 children, 29 with MIS-C exhibited these sequelae, with conjunctival injection, palmoplantar erythema, and lip hyperemia the most common, reported Vikash Oza, MD, of New York University Grossman School of Medicine, and colleagues, writing in a brief report in JAMA Dermatology.

Importantly, the authors noted, "mucocutaneous involvement was not associated with cardiac dysfunction, need for inotropic support, or intensive care unit admission, suggesting that mucocutaneous changes are not associated with disease severity in MIS-C."“

[...]

“The authors said while 60% of the cohort met criteria for Kawasaki disease or incomplete Kawasaki disease, there were "unique findings" not typically seen in patients with Kawasaki disease, including marked periorbital edema and "erythema reminiscent of heliotrope rash."“
 
CIDRAP

Black kids bear brunt of severe COVID-linked syndrome
Nov. 30, 2020

“The authors said that they don't know whether the MIS-C disparities observed in their study are part of the larger health inequities seen throughout the COVID-19 pandemic. "It is unclear whether this finding represents a phenomenon distinct from the increased burden of COVID-19 in Black and Hispanic communities, because we also observed a disproportionate burden of COVID-19 hospitalizations among Black and Hispanic children," they wrote.

The researchers called for larger studies to determine the relationship between MIS-C and race and understand the role of structural racism in perpetuating health inequities, as well as heightened vigilance in recognizing the syndrome in non-white children.

"Although MIS-C is uncommon, clinicians should be aware of the potential enhanced risk of this emerging syndrome among Black and Hispanic children," they said.“
 
Three children hospitalised with MIS-C
Dec. 5, 2020

“She said: "Unfortunately, we have three children that are hospitalised at our Couva facility suffering from a condition that you may have heard us talk about called MIS-C...These children had all the appropriate studies, support (and) input by the pediatricians and so on, and have all had studies inclusive of an echocardiogram. Unfortunately, these children have involvement of the heart. They're doing well but they do have involvement of the heart."“

[...]
https://www.looptt.com/content/three-children-hospitalised-mis-c
“She also had this message for parents: " The way to avoid your child from getting MIS-C is to avoid your child from getting COVID-19."“
 
Children with COVID-19 Blood Vessel Damage
December 9, 2020

“Investigators at the Children's Hospital of Philadelphia (CHOP) have found that a biomarker related to blood vessel damage was elevated in children with the coronavirus disease 2019 (COVID-19). This was true even if the children showed minimal or no symptoms of the virus.

A secondary finding identified that a high proportion of the children with the illness met diagnostic and clinical criteria for thrombotic microangiopathy (TMA), a syndrome that involves clotting in the small blood vessels.

The study, published in the journal Blood Advances, analyzed 50 pediatric patients at CHOP who were hospitalized with an acute COVID-19 infection. 18 of the patients were diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C)...”
 
Large study of hospitalized children with COVID-19 provides warning signs
Dec. 3, 2020

““Much of the discussion to date around COVID-19 suggests that children don’t typically suffer serious illness,” said lead author, Danielle Fernandes, M.D., attending physician, Division of Hospital Medicine, CHAM, and assistant professor of pediatrics at Einstein. “Our study shows that children with COVID-19, like adults, can experience symptoms ranging from mild to severe, and tragically, children can die from the disease.”“

[...]

“The paper is titled “SARS-CoV-2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth.” Co-authors include members of The Tri-State Pediatric COVID-19 Research Consortium from Albert Einstein College of Medicine, the Children’s Hospital at Montefiore, Yale School of Medicine, Kings County Hospital Center, Maimonides Children’s Hospital, Joseph M. Sanzari Children’s Hospital, K. Hovnanian Children’s Hospital, Neptune City, SUNY Downstate Medical Center University Hospital and Stony Brook University Renaissance Hospital.“

*more at link
 
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Local child being treated at Salt Lake hospital for COVID-19 related syndrome
Dec. 9, 2020

“It was not the flu;“

[...]

“Kale says, “We need to be more accountable. We need to come into the reality of what is happening. The idea that it is fake is embarrassing. MASKS NEED TO BE WORN! If this is how the disease is going to affect our children moving forward, they need to wear masks in school. I met with several specialists and they begged me to bring back the message that the kids need to wear masks in school. The kids take on the risk of having what has happened to Cooper happen to them. We need to educate our children and our adults. I was standing in line at the store and heard a teacher say ‘I’m never going to wear a mask.’ We buckle up our seatbelts when we drive, and we put on a coat when it’s cold. Why can’t we wear a mask when there is COVID?”

Cooper was a gifted and blessed athlete. He was going to do something with it. Now, he will never do those things. He will not be skiing this year. He will not be playing basketball. He can’t ride his motorbike anymore. He will have a heart injury for the rest of his life. All because of a syndrome related to having COVID-19.”
 
Courtesy via @sds71

This memorandum describes evidence recently obtained by the Select Subcommittee showing that a Trump Administration appointee at the Department of Health and Human Services (HHS), Senior Advisor Paul Alexander, privately strategized with other top Administration officials as far back as June 2020 about pursuing a so-called “herd immunity” strategy in response to the coronavirus pandemic. Dr. Alexander explicitly endorsed allowing the disease to spread widely among “nfants, kids, teens, young people, young adults, middle aged with no conditions etc.,” writing, “we use them to develop herd…we want them infected.”
Staff Report re Political Messaging and Herd Immunity.pdf (house.gov)
 
What parents need to know about how COVID-19 impacts kids’ brains

“Even with hope on the horizon amid a growing list of vaccines beginning to roll out, Song wants other parents to know the long-term effects of the virus on children. Bodi fully recovered from his MIS-C symptoms about four weeks after developing the illness. He has since excelled in school and graduated into the fourth grade along with his peers.

“Parents should be on the lookout for severe changes in their child’s ability to stay on task in school in the weeks after being diagnosed with COVID,” Song, who trained at Stanford, New York University and the University of California, San Francisco, told The Post. “If your child suddenly has trouble starting and completing homework assignments, remembering things they just learned, or if they get easily frustrated by the slightest changes to their schedules, these might be indicators the inflammation to the brain is affecting their cognitive capabilities.”“

[...]

“Although data is still limited on MIS-C, Song said recent research on Multisystem Inflammatory Syndrome in Adults (MIS-A) shows that there are potentially long-term cognitive-deficit complications that stem from the illness in grown-ups.”
 
margarita25 said:
Derm Symptoms Signal MIS-C in Kids
— Case series shows mucocutaneous findings in most children
Dec. 9, 2020

“Among 35 children, 29 with MIS-C exhibited these sequelae, with conjunctival injection, palmoplantar erythema, and lip hyperemia the most common, reported Vikash Oza, MD, of New York University Grossman School of Medicine, and colleagues, writing in a brief report in JAMA Dermatology.

Importantly, the authors noted, "mucocutaneous involvement was not associated with cardiac dysfunction, need for inotropic support, or intensive care unit admission, suggesting that mucocutaneous changes are not associated with disease severity in MIS-C."“

[...]

“The authors said while 60% of the cohort met criteria for Kawasaki disease or incomplete Kawasaki disease, there were "unique findings" not typically seen in patients with Kawasaki disease, including marked periorbital edema and "erythema reminiscent of heliotrope rash."“
Click to expand...

Mucocutaneous findings could indicate MIS-C
 
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