A Mysterious Inflammatory Illness in Kids May Be Linked to COVID-19: Our Physician-in-Chief Shares What We Know

So far throughout the COVID-19 pandemic, children and adolescents have mostly experienced mild symptoms or no symptoms at all. In contrast to adults, very few children have required hospitalization.

But in late April, health systems in the U.S., U.K. and Europe began reporting a new inflammatory illness in kids that appears to be linked to coronavirus. The new illness – known as multisystem inflammatory syndrome in children (MIS-C) or pediatric multisystem inflammatory syndrome (PMIS) – is very rare, but can be life-threatening if left untreated.

Doctors, including Connecticut Children’s own experts, are still working to learn more about the condition.

Physician-in-Chief Juan C. Salazar, MD, MPH, shares what we know so far.

What are the symptoms of this new illness?

The most common signs are a persistent fever over 101 degrees and stomach pain, sometimes accompanied by the other symptoms below. Many of the symptoms look like a typical childhood illness, and they vary from child to child.

Call a doctor immediately if your child has:

• Fever of 101 degrees or more for more than three days
• Difficulty feeding (infants) or too sick to drink fluids
• Severe abdominal pain, diarrhea or vomiting
• Cracked lips
• Reddish eyes (similar to pinkeye)
• Rash, usually over a large area, and often on the hands, forearms and chest
• Swollen glands/lymph nodes
• Change in skin color (becoming pale, patchy and/or blue)
• Racing heart or chest pain
• Decreased amount or frequency of urine
• Lethargy, irritability or confusion

If my child is showing any of the above symptoms, what should I do?

Call your child’s doctor right away. They can help identify the cause of the symptoms and the care your child needs. Connecticut Children’s Pediatric COVID-19 Hotline is available 24/7 at 833.226.2362.

Is the illness serious?

If left untreated, yes. It seems to involve an exaggerated immune response, which can have serious effects on the heart and other organs if not addressed. Call a doctor right away if your child is showing symptoms.

How common is this new illness?

So far, it appears to be rare: The number of reported cases worldwide has been very small (although that may change as health systems learn what to look for in reporting cases). In the U.S. the greatest number of reported cases – about 100 – have been in New York State. A handful of cases have been reported in other states including Louisiana, Connecticut, Massachusetts, Mississippi and California. There have been at least 50 cases reported in European countries, including Britain, France, Switzerland, Spain and Italy.

Is this illness linked to COVID-19?

It seems to be. Some children tested positive for COVID-19 at the time they were seen for this new illness. A larger number showed antibodies for COVID-19, meaning they might previously have been infected with the coronavirus. This all suggests that the new inflammatory syndrome may be a delayed reaction to the coronavirus, driven by a child’s immune system response to COVID-19. Doctors are working to learn more.

What are the ages of the children who have been affected?

In the cases reported so far, children have been as young as infants and as old as young adults.

Why have I been hearing about Kawasaki disease? Is this new illness the same thing?

Kawasaki disease is a rare childhood illness. Many of the symptoms look similar to this new illness, perhaps because both diseases appear to involve inflammation in the body. But as doctors learn more about this new illness, they are increasingly confident that it is not the same as Kawasaki disease.

What is the treatment for this new illness?

So far, treatments have included high-dose aspirin and antibiotics, steroids, intravenous immunoglobulin (antibodies that help the body fight infection), as well as supportive oxygen through the nose, a mask or, in the most serious cases, a ventilator.

What is Connecticut Children’s doing to keep my child safe from this new illness?

We are working closely with pediatric practices to make sure primary care physicians are aware of this illness, its symptoms, and what to do if a child may be experiencing it. At our own facilities, we continue to work tirelessly to create an infection-free environment for our children, team members and community, and we are prepared with the necessary equipment and supplies to treat any children who may experience this illness.

Anything else I should know?

So far, this illness has been very rare. But because it can be serious, it’s important to call your child’s doctor right away if you notice any symptoms. In the meantime, continue wearing a mask, social distancing and practicing great hygiene to minimize your child’s and your exposure to the coronavirus.

Connecticut Children’s Pediatric COVID-19 Hotline is available 24/7 at 833.226.2362.

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