Yes, some children have CV and some do not. From the last article I posted:
"The 14-year-old, Jack McMorrow, "He was rushed to the ICU and tested positive for COVID-19. John McMorrow is his father."
Some of the other children I post over the last week also tested positive
Kawasaki Disease From COVID-19 in Kids: How Common?
The first known published case of classic Kawasaki disease associated with COVID-19
was reported in Hospital Pediatrics in late April. A 6-month-old seen in Stanford, California, screened positive for COVID-19 after presenting with fever, blotchy rash, and minimal respiratory symptoms. She had initially been sent home from urgent care.
This week, the New York City Health Department
announced finding 15 cases between April 29 and May 3. The "full spectrum of disease is not yet known," it noted. "Only severe cases may have been recognized at this time."
On Wednesday, the New York State Department of Health expanded that to
64 cases statewide and issued an advisory on what is being called "Pediatric Multi-System Inflammatory Syndrome Temporally Associated with COVID-19."
Two children are now known to have died in New York with the syndrome, a 5-year-old boy and a 7-year-old boy.
Italy, Spain, and the U.K. have noted an uptick in Kawasaki-like disease among children coincident with the COVID-19 outbreaks there.
British health authorities warned about a small rise in children with severe COVID-19 and features consistent with toxic shock syndrome and atypical Kawasaki disease. "Abdominal pain and gastrointestinal symptoms have been a common feature as has cardiac inflammation."
Even under normal circumstances, it can be difficult to sort out Kawasaki disease from other childhood diseases that cause similar symptoms given that there are no definitive blood tests, noted Michael Portman, MD, of Seattle Children's Hospital and a member of the American College of Cardiology committee that set benchmarks for care of Kawasaki disease.
"What's really unusual about this particular presentation is that they are older," noted Deepika Thacker, MD, medical director for the cardiac inpatient unit at Nemours Children's Health System in Wilmington, Delaware.
Kawasaki disease typically affects children age 5 years and younger, but many of these cases reported have been in teens, she pointed out.
In the NYC health department report, the 15 cases in children ages 2 to 15 years were hospitalized with typical or incomplete Kawasaki disease, some with shock. All had fever and more than half had rash, abdominal pain, vomiting, or diarrhea. However, less than half have had respiratory symptoms.
Some cases have even been described where severe abdominal pain sent these children to surgery but nothing was found, Thacker noted in an interview monitored by her institution's media relations. Bloodwork has also been following a "very different pattern," she said, including markers of cardiac injury higher than typically seen with Kawasaki disease.
"Whilst it is too early to say with confidence, features appear to include high CRP [C-reactive protein], high ESR [erythrocyte sedimentation rate] and high ferritin," Britain's Pediatric Intensive Care Society said in a
statement.
The New York state alert also pointed to myocarditis and other cardiovascular changes that may be seen. "Additionally, some patients have developed cardiogenic or vasogenic shock and required intensive care. This inflammatory syndrome may occur days to weeks after acute COVID-19 illness."
Missed Cases
While most children who develop Kawasaki disease recover without incident, "there's still that 25% out there that if they get late treatment, they could have serious illnesses.
And some of those children, the fever goes away and they're walking around with a coronary artery aneurysm and they don't even know it," Portman noted.
(and the article continues to this info)
One community-based study is the National Institute of Allergy and Infectious Diseases (NIAID)'s 6,000-person
HEROS study looking into the rate of SARS-CoV-2 infection in U.S. children and their family members, which collects nasal swab and blood samples from participants every 2 weeks.
https://www.medpagetoday.com/infectiousdisease/covid19/86393
The Heros Study
Study to determine incidence of novel coronavirus infection in U.S. children begins
NIH-funded study also will ascertain percentage of infected children who develop COVID-19.
The study, called Human Epidemiology and Response to SARS-CoV-2 (HEROS), also will help determine what percentage of children infected with SARS-CoV-2, the virus that causes COVID-19, develop symptoms of the disease. In addition, the HEROS study will examine whether rates of SARS-CoV-2 infection differ between children who have asthma or other allergic conditions and children who do not. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is sponsoring and funding the HEROS study.
“One interesting feature of this novel coronavirus pandemic is that very few children have become sick with COVID-19 compared to adults,” said NIAID Director Anthony S. Fauci, M.D. “Is this because children are resistant to infection with SARS-CoV-2, or because they are infected but do not develop symptoms? The HEROS study will help us begin to answer these and other key questions.”
“So far, data on the extent of SARS-CoV-2 infection in the U.S. population have been limited to people who physically interact with the healthcare system: those who are tested―especially those who test positive―and those with severe disease,” said Dr. Hartert. “These data provide real-time guidance in a setting of limited test availability, but they don’t enable us to understand the full extent of SARS-CoV-2 infection in the entire population. The HEROS study will help fill this knowledge gap and inform public health interventions.”
Preliminary evidence suggests that having an allergic condition paradoxically may reduce a person’s susceptibility to SARS-CoV-2 infection and severe COVID-19 disease.
A NIAID-funded study(link is external) recently examined upper and lower airway cells for the expression of
ACE2, the gene that codes for the receptor that the coronavirus uses to infect cells.
ACE2 expression is necessary for a cell to make this receptor, but additional steps also are involved. In both children and adults, respiratory allergy, asthma and controlled allergen exposure were associated with significantly reduced
ACE2 expression. The expression of
ACE2 was lowest in people with high levels of both asthma and sensitivity to allergens.
The HEROS study will further clarify whether reduced
ACE2 gene expression in airway cells of children with allergic diseases correlates with a lower rate of SARS-CoV-2 infection and COVID-19.
Study to determine incidence of novel coronavirus infection in U.S. children begins
Researchers remain uncertain if this is being caused by COVID-19, but most children appear to have a link. Some affected children have tested positive for coronavirus antibodies, suggesting that the inflammation is "delayed," Nancy Fliesler of
Boston Children's Hospital wrote on Friday.
Doctors have described children "screaming from stomach pain" while hospitalized for shock, Jane Newburger of Boston Children's Hospital
told the Washington Post.
More information is trickling in from various places.
As some children go into inflammatory shock, doctors urgently study COVID-19 in kids
--Why are children largely spared from COVID-19 — and why do a tiny handful become
extremely sick? To find out, Boston Children’s Hospital has launched a national study to perform real-time surveillance at more than 35 U.S. children’s hospitals.
Called Overcoming COVID-19, the study has $2.1 million in funding from the Centers for Disease Control and Prevention. It will capture real-time data on 800 children and youth up to age 25 hospitalized with COVID-19, in search of factors that increase vulnerability to the novel coronavirus — but also what protects the vast majority of kids.
National study tracks COVID-19 in children - Boston Children's Discoveries
