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

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(Posting for reference and further review, although MIS-C is not mentioned in the snippet, link courtesy via @imstilla.grandma)


“Since the start of the COVID-19 pandemic, more than 1 million infants, children and adolescents have been diagnosed with the illness, according to data released Monday by the American Academy of Pediatrics and Children’s Hospital Association, which are tracking data reported by state health departments.

As of Nov. 12, a total of 1,039,464 children have tested positive for COVID-19 since the onset of the pandemic. In the one-week period ending Nov. 12th, there were 111,946 new cases in children, which is substantially larger than any previous week in the pandemic. The increase tracks surges in the virus in communities across the U.S.

“As a pediatrician who has practiced medicine for over three decades, I find this number staggering and tragic. We haven’t seen a virus flash through our communities in this way since before we had vaccines for measles and polio,” said AAP President Sally Goza, MD, FAAP. “And while we wait for a vaccine to be tested and licensed to protect children from the virus that causes COVID-19, we must do more now to protect everyone in our communities. This is even more important as we approach winter, when people will naturally spend more time indoors where it is easier for the virus to be transmitted.”

More Than 1 Million Children in U.S. Diagnosed with COVID-19
 
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Nov. 17, 2020

COVID-19 and MIS-C: Two Diseases, One Virus in Kids
— Both clinical profiles and even outcomes varied, researcher says


“Pediatric patients with acute COVID-19 and those with multi-system inflammatory syndrome in children (MIS-C) had evidence of acute liver injury, but each group had different clinical features, a researcher said.

MIS-C patients were younger, had more ICU admissions, and higher levels of inflammatory markers, while COVID-19 patients with acute liver injury were more likely to have higher BMI, reported Amanda Cantor, MD, of Columbia University in New York City.

In fact, BMI was significantly associated with degree of liver injury among kids with COVID-19, but not MIS-C, she said in a presentation at theAmerican Association for the Study of Liver Diseases virtual meeting.

Cantor described how there were "two distinct clinical phenotypes caused by the same virus." She and her colleagues added that MIS-C "changed the perception of the severity of this infection in children," as pediatric manifestations of COVID-19 in children were thought to be mild.“
 
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W. MI child’s death linked to COVID-19 | WOODTV.com
Nov. 21, 2020

“GRAND RAPIDS, Mich. (WOOD) — A West Michigan child has died from complications thought to be directly related to coronavirus.”

[...]

“Unfortunately, we’ve been seeing cases of MIS-C at Helen DeVos Children’s Hospital. It’s a byproduct of coronavirus that we’re not totally sure of the whole connection,” said Dr. Daniel McGee, pediatric hospitalist.

The hospital says it couldn’t give specifics about the child’s age or when the child died.

However, officials say several children have been admitted to the hospital with MIS-C over the last few months.

“We’ve had at least a few patients hospitalized because of it. In the last week, there were at least two,” he said.““
 
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MIS-C in Atlanta child who had COVID-19 | wtsp.com
Mattapoisett boy battles COVID-19 and MIS-C
Nov. 25, 2020

“Dr. Brian Sard, the chair of pediatrics and director of the Boston Children's Hospital program at St. Luke's, said that MIS-C can present itself after acute COVID-19 exposure has passed. In Cooney's case, MIS-C symptoms of fever and rash followed his mild cold symptoms. Sard said that MIS-C can present itself in a constellation of symptoms similar to those in Kawasaki disease such as red eyes, swollen glands, rash, mucositis, swelling of hands or feet and GI problems.

Xifaras, herself a nurse, said a slew of new symptoms appeared over the next few days.

"It's unnerving because this isn't like an ear infection or strep throat where you know what's next," she said. "Every day there is something new."

de07fda9-3d40-4634-a88a-0d5001a106de-Cooney_Family2.jpg


According to Dr. Reynolds, Cooney's fever improved but then spiked again and he developed a severe pain in his left hip. The doctors were worried about toxic synovitis, where the soft tissue of a joint becomes inflamed. Cooney was admitted to Boston Children's Hospital to be further treated. Upon being admitted, he tested negative for COVID-19. As of Monday, it was confirmed by rheumatology that he had a mild case of MIS-C but there is still concern for the residual cardiac effect.“



YOUNG BOY ON THE UP AND UP FOLLOWING SERIOUS HEALTH SCARE - Florida Keys Weekly Newspapers
Nov. 25, 2020




“Before Zane was admitted, no symptoms of COVID-19 were apparent. Three tests performed came back negative. It wasn’t until a 105-degree fever that Leah knew something was seriously wrong.

A positive antibodies test, however, led doctors to the belief that Zane had multisystem inflammatory syndrome, or MIS-C. While some eventually improve with medial care, others get worse — as was the case for Zane. With dips in his condition, from swelling to rash, came improvements, to the point of his release from the hospital on Aug. 4.

Today, Zane’s parents say his health is improving with his organs shrinking and returning to normal. Doctors continue to closely monitor an enlarged left lung artery and a heart murmur he developed through the illness, however.”

[...]

“Zane has faced several life-threatening issues in his young life, as Dr. Stan Zuba said MIS-C attacked the young boy’s body so aggressively that there were times he didn’t know if he was going to pull through. But he did, Zuba says, with outstanding and state-of-the-art care and treatment at Nicklaus Children’s Hospital.“

—-

MIS-C in Atlanta child who had COVID-19 | wtsp.com
Nov. 25, 2020

“The Vasey Family thought they had beaten COVID-19.

It had been a few weeks and they were all feeling great but then Vivian started to get sick again, and they couldn't figure out what was wrong.

"I walk in to her room, and she's in a ball on the floor. And she's like, 'Mommy, my legs don't work. I can't walk,'" said Miranda Vasey.”

[...]

“"MIS-C, we only have data that goes back 10 months. From my understanding, we have only had 15,000 cases. So we don't know what the long-term effects of this will be on our child," she said.

In Georgia, there have been 83 confirmed cases of the disease according to the health department. Nationwide, there have been 20 pediatric deaths.

While the CDC classifies MIS-C as rare, the doctors treating Vivian told her family they're seeing a kid a week show up with symptoms.

"Parents need to know that kids can get really sick. You can't trust people to do the right thing, and if your child gets COVID-19, you need to have MIS-C on your radar, and you need to know that between two to four weeks later your child can get really sick," she said.”
-

MIS-C: What to know about the COVID-19 related illness seen in kids
Nov. 16, 2020

“Twelve-year-old Madilyn Dayton's symptoms began with a headache and body aches.

Two to three days later, she couldn't walk or eat, and rashes appeared all over her body.

Then, she couldn't move at all.

"I remember my mom driving me to the hospital... and then I woke up in the ICU the next morning," she said.“

-

Hudson Asche returns home to recover from MIS-C
Nov. 10, 2020

5fa974511b10d.image.png

Hudson

BBM:
“On Hudson's caringbridge.org page, his mother Dana said he arrived back home last Sunday night, and he is still feeling "very sick and the doctors explained he is not going to just bounce back but it will take weeks to start feeling better, and close to 6 months before he feels back to normal." Dana said COVID and MIS-C have weakened Hudson and he will be going to physical therapy 2 to 3 times a week.“
 
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“News 8: Kids are often thought to be less at risk for developing severe cases of COVID-19, but can you explain how MIS-C impacts into that?
McGee: The majority of children will get through coronavirus just fine. The problem is the ones who get sick, get really sick, and can even die of the infection or some consequences of the infection.

News 8: Does the severity of a child’s COVID-19 infection influence the likelihood of that child contracting MIS-C?
McGee: There’s no data that connects how severe a coronavirus infection is and if the child will get MIS-C. So, it can be kind of random. We don’t have a good explanation as to why some children get it and not others.

News 8: What’s it like treating these patients?
McGee: I’d rather not have to do it. These are children that can get very, very sick and as I’ve said before some of these kids can die. This virus is real. This virus is dangerous. It doesn’t matter whether you’re a child or an adult. So, we all have to be careful to make sure we don’t get it because your child could be the one that suffers from a major consequence.“

[...]

“News 8: Is MIS-C contagious from one person to another?
McGee: No, MIS-C is not in itself contagious. People who have it will not spread it to other people. The coronavirus that seems to trigger it, obviously, that’s contagious.“

W. MI child’s death linked to COVID-19 | WOODTV.com
Nov. 21, 2020



“It’s estimated at the least that more than 1 million children (under the age of 18) in the U.S. are, or have been, infected with COVID-19.

While kids are often reported to have less severe symptoms, Wheeler said that should not give blanket comfort.

“The concern though is there is still a subset of children who go on to develop more severe symptoms and symptoms that require hospitalization,” Wheeler said.

Kids are often believed to transmit COVID-19 at a lesser rate than adults, but Wheeler said it is a risk that remains concerning.

Youth will also be a focal point as pharmaceutical companies get closer to releasing a COVID-19 vaccine.

“We need to make sure we’re paying attention to our pediatric population,” Wheeler said. “We have so much focus on adults getting sick and we need to remember that kids are impacted too. Kids aren’t little adults, kids need their own research, their own data, and we need to be cautious.

"While kids are doing well in general with COVID, there are still some getting really sick and we need to be doing everything we can to protect not only our adult population, but to be protecting our kids as well.”“

Experts Concerned About Florida Spike in Child COVID-19 Cases
 
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Norfolk hospital has treated 7 children for rare coronavirus-linked syndrome
Nov. 15, 2020

“Virginia has reported only 11 cases statewide, most were in the northern region. None of the seven patients treated at Children’s Hospital of The King’s Daughters — the only freestanding pediatric medical facility in the state — are included in that tally, which came to light after inquiries from The Virginian-Pilot.

Most children with MIS-C have a fever lasting several days and symptoms such as irritability, abdominal pain, diarrhea, vomiting, rash, conjunctivitis, lack of appetite, red or cracked lips, red or bumpy tongue or swollen hands and feet. Some medical experts have likened it to other hyperinflammatory conditions, such as Kawasaki disease and toxic shock syndrome.“

[...]

“Nelson Delacruz, an epidemiologist for the state, confirmed the hospital’s cases had been reported. But while public health investigators counted them toward Virginia’s COVID-19 cases, they did not for MIS-C.

That’s because the department did not consider them to meet the U.S. Centers for Disease Control and Prevention’s narrow definition for the syndrome. Delacruz could not elaborate on how the cases differed.“



CDC:

“Clinical Presentation
Patients with MIS-C usually present with persistent fever, abdominal pain, vomiting, diarrhea, skin rash, mucocutaneous lesions and, in severe cases, with hypotension and shock. They have elevated laboratory markers of inflammation (e.g., CRP, ferritin), and in a majority of patients laboratory markers of damage to the heart (e.g., troponin; B-type natriuretic peptide (BNP) or proBNP). Some patients develop myocarditis, cardiac dysfunction, and acute kidney injury. Not all children will have the same signs and symptoms, and some children may have symptoms not listed here. MIS-C may begin weeks after a child is infected with SARS-CoV-2. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected.”

Multisystem Inflammatory Syndrome in Children (MIS-C)
 
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“While some cases of the coronavirus tend to be mild for children, more than 1,000 children have developed multisystem inflammatory syndrome in children (MIS-C). It’s a rare but serious complication that can occur after COVID-19 infection.

Four-year-old K.J. Griffin is the first child in the country to receive an experimental treatment for MIS-C. His mom, Talaiyah Stephens, cannot believe she came so close to losing him.”

[...]

“Dr. Allison Eckard, division director of pediatric infectious diseases at Medical University of South Carolina says, “His body was no longer pumping blood effectively to his vital organs, and they were starting to shut down.”

K.J. received high dose steroids, and aspirin, and plasma, as well as other drugs to help prevent blood clots. Doctors determined he was also a candidate for an experimental treatment called Remestemcel-L, which uses donor bone marrow cells to regulate the immune system.

“It acts as if that person is making those cells themselves, and so they circulate in the blood and release anti-inflammatory cytokines,” Dr. Eckard says. “The thought is that not only does it turn down inflammation, but it actually repairs some of the damage that’s been done.”“

Over 1,000 Children Have Developed Multisystem Inflammatory Syndrome After Contracting COVID
Nov. 24, 2020
 
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“The data shows a rapid climb in new cases beginning at the end of October. The timing coincides with the transition of the first marking period to the second marking period, and a deadline to when parents had to decide whether to switch between in-person learning and at-home virtual learning.

While school districts have rolled out exhaustive cleaning efforts and procedures to keep contact limited, the question for education and health officials is what impact in-person learning has had on the growing cases.”

Experts Concerned About Florida Spike in Child COVID-19 Cases
Nov. 24, 2020
 
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(Courtesy via @weepingangel)

Assessment of 135 794 Pediatric Patients Tested for SARS-CoV-2 Across the United States
November 23, 2020

“In addition to respiratory illness, concerns have arisen around multisystem inflammatory syndrome in children (MIS-C).13 An Italian series of 10 cases of Kawasaki-like syndrome included 8 patients with antibodies against SARS-CoV-2.14 New York state has reported more than 100 cases of Kawasaki-like disease, including 3 deaths, among children with COVID-19.15 Our evolving knowledge of MIS-C suggests that available evidence may be revealing only a partial picture of the effect of COVID-19 in the pediatric population.“
 
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IMO, by no mean are kids out of the woods with this. As for rare, what does one consider rare? A hundred kids? A thousand kids? Ten thousand kids? These numbers are increasing. We need to start protecting the children, jmo, even if many may escaped unscathed. We do not know the long term effects fully. And it is evident that some children ARE experiencing them.

One must realize that these are only some of the cases that we are hearing about / I have consolidated and bolded some significant notes.

MIS-C in Atlanta child who had COVID-19 | wtsp.com

Mattapoisett boy battles COVID-19 and MIS-C
Nov. 25, 2020

“Dr. Brian Sard, the chair of pediatrics and director of the Boston Children's Hospital program at St. Luke's, said that MIS-C can present itself after acute COVID-19 exposure has passed. In Cooney's case, MIS-C symptoms of fever and rash followed his mild cold symptoms. Sard said that MIS-C can present itself in a constellation of symptoms similar to those in Kawasaki disease such as red eyes, swollen glands, rash, mucositis, swelling of hands or feet and GI problems.

Xifaras, herself a nurse, said a slew of new symptoms appeared over the next few days.

"It's unnerving because this isn't like an ear infection or strep throat where you know what's next," she said. "Every day there is something new."

de07fda9-3d40-4634-a88a-0d5001a106de-Cooney_Family2.jpg


BBM:
According to Dr. Reynolds, Cooney's fever improved but then spiked again and he developed a severe pain in his left hip. The doctors were worried about toxic synovitis, where the soft tissue of a joint becomes inflamed. Cooney was admitted to Boston Children's Hospital to be further treated. Upon being admitted, he tested negative for COVID-19. As of Monday, it was confirmed by rheumatology that he had a mild case of MIS-C but there is still concern for the residual cardiac effect.


YOUNG BOY ON THE UP AND UP FOLLOWING SERIOUS HEALTH SCARE - Florida Keys Weekly Newspapers
Nov. 25, 2020



“Before Zane was admitted, no symptoms of COVID-19 were apparent. Three tests performed came back negative. It wasn’t until a 105-degree fever that Leah knew something was seriously wrong.

A positive antibodies test, however, led doctors to the belief that Zane had multisystem inflammatory syndrome, or MIS-C. While some eventually improve with medial care, others get worse — as was the case for Zane. With dips in his condition, from swelling to rash, came improvements, to the point of his release from the hospital on Aug. 4.

Today, Zane’s parents say his health is improving with his organs shrinking and returning to normal. Doctors continue to closely monitor an enlarged left lung artery and a heart murmur he developed through the illness, however.

[...]

“Zane has faced several life-threatening issues in his young life, as Dr. Stan Zuba said MIS-C attacked the young boy’s body so aggressively that there were times he didn’t know if he was going to pull through. But he did, Zuba says, with outstanding and state-of-the-art care and treatment at Nicklaus Children’s Hospital.“
—-

MIS-C in Atlanta child who had COVID-19 | wtsp.com
Nov. 25, 2020

“The Vasey Family thought they had beaten COVID-19.

It had been a few weeks and they were all feeling great but then Vivian started to get sick again, and they couldn't figure out what was wrong.

"I walk in to her room, and she's in a ball on the floor. And she's like, 'Mommy, my legs don't work. I can't walk,'" said Miranda Vasey.”

[...]

“"MIS-C, we only have data that goes back 10 months. From my understanding, we have only had 15,000 cases. So we don't know what the long-term effects of this will be on our child," she said.

In Georgia, there have been 83 confirmed cases of the disease according to the health department. Nationwide, there have been 20 pediatric deaths.

While the CDC classifies MIS-C as rare, the doctors treating Vivian told her family they're seeing a kid a week show up with symptoms.

"Parents need to know that kids can get really sick. You can't trust people to do the right thing, and if your child gets COVID-19, you need to have MIS-C on your radar, and you need to know that between two to four weeks later your child can get really sick," she said.”

-

MIS-C: What to know about the COVID-19 related illness seen in kids
Nov. 16, 2020

“Twelve-year-old Madilyn Dayton's symptoms began with a headache and body aches.

Two to three days later, she couldn't walk or eat, and rashes appeared all over her body.

Then, she couldn't move at all.

"I remember my mom driving me to the hospital... and then I woke up in the ICU the next morning," she said.“
--

Hudson Asche returns home to recover from MIS-C
Nov. 10, 2020

5fa974511b10d.image.png

Hudson

“On Hudson's caringbridge.org page, his mother Dana said he arrived back home last Sunday night, and he is still feeling "very sick and the doctors explained he is not going to just bounce back but it will take weeks to start feeling better, and close to 6 months before he feels back to normal." Dana said COVID and MIS-C have weakened Hudson and he will be going to physical therapy 2 to 3 times a week.“


Pediatricians call number of children with COVID "staggering and tragic" - WISH-TV | Indianapolis News | Indiana Weather | Indiana Traffic


Southern Indiana boy, 6, hospitalized with rare COVID-related syndrome MIS-C

Long Recovery Ahead For Minn. Teen Who Contracted Rare COVID-Related Syndrome MIS-C

Teen facing long recovery after suffering rare COVID-related syndrome

Little boy who died in Lubbock hospital after MIS-C was 3rd grader from Odessa

WATCH: Covenant Children’s hosts news conference to discuss a rise in cases of MIS-C in West Texas

Research Roundup: COVID; MIS-C; Leukemia; Childhood Cancer

Multi-system inflammatory syndrome, how's related to coronavirus | abc10.com
'My son almost died.' Mom issues warning after son is diagnosed with MIS-C which is connected to COVID-19
A pediatrician at Norton Children's Hospital said they've treated about a dozen children with multi-symptom inflammatory syndrome (MIS-C).


W. MI child’s death linked to COVID-19 | WOODTV.com
Nov. 21, 2020

GRAND RAPIDS, Mich. (WOOD) — A West Michigan child has died from complications thought to be directly related to coronavirus.”

[...]

“Unfortunately, we’ve been seeing cases of MIS-C at Helen DeVos Children’s Hospital. It’s a byproduct of coronavirus that we’re not totally sure of the whole connection,” said Dr. Daniel McGee, pediatric hospitalist.

The hospital says it couldn’t give specifics about the child’s age or when the child died.

However, officials say several children have been admitted to the hospital with MIS-C over the last few months.

“We’ve had at least a few patients hospitalized because of it. In the last week, there were at least two,” he said.““


Florida:

“There were 5,970 pediatric coronavirus cases Monday, compared to 1,657 on October 5

Data shows a rapid increase in pediatric COVID-19 cases since early October”


Experts Concerned About Florida Spike in Child COVID-19 Cases


Nov. 24
Over 1,000 Children Have Developed Multisystem Inflammatory Syndrome After Contracting COVID

Nov. 19
6-year-old diagnosed with MIS-C released from hospital

Nov. 17
COVID, MIS-C show evidence of liver injury, require long-term monitoring

Higher SARS-CoV-2 antibody titers in patients hospitalized with MIS-C | 2 Minute Medicine

Nov. 16
A serious illness related to COVID-19 is showing up in Utah kids. Here's what you need to know
MIS-C: What to know about the COVID-19 related illness seen in kids

Nov. 15
Norfolk hospital has treated 7 children for rare coronavirus-linked syndrome


“While some cases of the coronavirus tend to be mild for children, more than 1,000 children have developed multisystem inflammatory syndrome in children (MIS-C). It’s a rare but serious complication that can occur after COVID-19 infection.

Four-year-old K.J. Griffin is the first child in the country to receive an experimental treatment for MIS-C. His mom, Talaiyah Stephens, cannot believe she came so close to losing him.”

[...]

“Dr. Allison Eckard, division director of pediatric infectious diseases at Medical University of South Carolina says, “His body was no longer pumping blood effectively to his vital organs, and they were starting to shut down.”

K.J. received high dose steroids, and aspirin, and plasma, as well as other drugs to help prevent blood clots. Doctors determined he was also a candidate for an experimental treatment called Remestemcel-L, which uses donor bone marrow cells to regulate the immune system.

“It acts as if that person is making those cells themselves, and so they circulate in the blood and release anti-inflammatory cytokines,” Dr. Eckard says. “The thought is that not only does it turn down inflammation, but it actually repairs some of the damage that’s been done.”“

Over 1,000 Children Have Developed Multisystem Inflammatory Syndrome After Contracting COVID
Nov. 24, 2020


Boy under age of 10 becomes Manitoba's youngest COVID-19 victim, 487 new cases reported
Nov. 28, 2020

“An additional 10 deaths due to COVID-19 were announced Saturday by public health officials including a boy under the age of 10 from Winnipeg, the youngest Manitoba victim since the pandemic began.“


Experts Concerned About Florida Spike in Child COVID-19 Cases

“It’s estimated at the least that more than 1 million children (under the age of 18) in the U.S. are, or have been, infected with COVID-19.

While kids are often reported to have less severe symptoms, Wheeler said that should not give blanket comfort.

“The concern though is there is still a subset of children who go on to develop more severe symptoms and symptoms that require hospitalization,” Wheeler said
.

Kids are often believed to transmit COVID-19 at a lesser rate than adults, but Wheeler said it is a risk that remains concerning.

Youth will also be a focal point as pharmaceutical companies get closer to releasing a COVID-19 vaccine.

We need to make sure we’re paying attention to our pediatric population,” Wheeler said. “We have so much focus on adults getting sick and we need to remember that kids are impacted too. Kids aren’t little adults, kids need their own research, their own data, and we need to be cautious.

"While kids are doing well in general with COVID, there are still some getting really sick and we need to be doing everything we can to protect not only our adult population, but to be protecting our kids as well.”“


COVID-19 and MIS-C: Two Diseases, One Virus in Kids
— Both clinical profiles and even outcomes varied, researcher says

Nov. 17, 2020

“Pediatric patients with acute COVID-19 and those with multi-system inflammatory syndrome in children (MIS-C) had evidence of acute liver injury, but each group had different clinical features, a researcher said.

MIS-C patients were younger, had more ICU admissions, and higher levels of inflammatory markers, while COVID-19 patients with acute liver injury were more likely to have higher BMI, reported Amanda Cantor, MD, of Columbia University in New York City.

In fact, BMI was significantly associated with degree of liver injury among kids with COVID-19, but not MIS-C, she said in a presentation at theAmerican Association for the Study of Liver Diseases virtual meeting.

Cantor described how there were "two distinct clinical phenotypes caused by the same virus." She and her colleagues added that MIS-C "changed the perception of the severity of this infection in children," as pediatric manifestations of COVID-19 in children were thought to be mild.“


Now, keep in mind, this is just one hospital, and as seen in the above, this is not the only hospital to say they are seeing more and more patients:

“While the CDC classifies MIS-C as rare, the doctors treating Vivian told her family they're seeing a kid a week show up with symptoms.“


MIS-C in Atlanta child who had COVID-19 | wtsp.com


News 8: What’s it like treating these patients?
McGee: I’d rather not have to do it. These are children that can get very, very sick and as I’ve said before some of these kids can die. This virus is real. This virus is dangerous. It doesn’t matter whether you’re a child or an adult. So, we all have to be careful to make sure we don’t get it because your child could be the one that suffers from a major consequence.“


Re: Here is another reason why I think it’s possible we are not seeing the full spectrum here:

“Nelson Delacruz, an epidemiologist for the state, confirmed the hospital’s cases had been reported. But while public health investigators counted them toward Virginia’s COVID-19 cases, they did not for MIS-C.

That’s because the department did not consider them to meet the U.S. Centers for Disease Control and Prevention’s narrow definition for the syndrome.
Delacruz could not elaborate on how the cases differed.“



CDC:

“Clinical Presentation
Patients with MIS-C usually present with persistent fever, abdominal pain, vomiting, diarrhea, skin rash, mucocutaneous lesions and, in severe cases, with hypotension and shock. They have elevated laboratory markers of inflammation (e.g., CRP, ferritin), and in a majority of patients laboratory markers of damage to the heart (e.g., troponin; B-type natriuretic peptide (BNP) or proBNP). Some patients develop myocarditis, cardiac dysfunction, and acute kidney injury. Not all children will have the same signs and symptoms, and some children may have symptoms not listed here. MIS-C may begin weeks after a child is infected with SARS-CoV-2. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected.”

Multisystem Inflammatory Syndrome in Children (MIS-C)
 
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