Some leading pediatricians are calling on NYC health officials to begin tracking a possible connection between COVID-19 and toxic shock in children, after some local hospitals started seeing pediatric patients with severe inflammatory symptoms.
“We need to understand if this is actually a new phenomenon,” said Dr. Sean O’Leary, an infectious disease specialist with the American Association of Pediatrics in an interview with Wednesday. “It’s all so new that there are a lot of questions that we need to get answered."
On Tuesday, NBC New York was first to report that doctors are exploring the possible link in several pediatric patients at Mount Sinai Kravis Children’s Hospital and in at least one toddler hospitalized earlier this week at NYU Langone. But New York City Health officials say they are unaware of any trends in this area and declined to say whether they would adjust their surveillance procedures to begin tracking cases of pediatric inflammatory disease as a possible byproduct of COVID-19.
"We meet on a regular basis through webinars with doctors at the ICUs at all of the hospitals and we have not seen this to date,” said New York City Health Commissioner Oxiris Barbot at a news conference on Wednesday. “To date, we have not heard of ways in which the coronavirus has been affecting children’s cardiovascular systems,” Barbot added.
But on Thursday, New York State Health Commissioner Howard Zucker acknowledged the state was aware of a few cases of kids with a toxic shock-like syndrome potentially connected to the coronavirus. He did not say exactly how many or where but said it was an issue he had discussed with hospital medical directors and health officials in other states.
On Sunday, UK health officials issued a warning about a possible link between COVID-19 and serious inflammatory disease in children, after at least a dozen children with the coronavirus there developed secondary illness and shock.
Inside Mount Sinai’s ICU this week, more than two children were exhibiting symptoms of the sickness known as Kawasaki Disease, including toxic shock, according to a hospital source who asked not to be identified. At least one of those children also tested positive for COVID-19, leaving staff to wonder if they are seeing the same link that prompted British pediatric specialists to issue the alert on Sunday.
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A third child at NYU Langone hospital was also diagnosed last week with the inflammatory condition, according to family members who say it was a terrifying experience. Their daughter, a toddler, went to the ER on April 23 after several days of high fever that eventually spiked to 106 degrees. The child is now recovering at home, according to her mother who asked not to be identified. “The experience was terrifying but we are relieved and grateful that she is okay. The hospital was really amazing at identifying the source and treating it.”
The child tested negative for coronavirus, but her mother says doctors suspect her inflammatory symptoms might be linked to an undetected COVID infection from several weeks ago, when other members of the child's household were sick.
“I’m very worried about the early signs that in rare cases there’s an autoimmune response in children that causes a significant disease,” UK Health Secretary Matt Hancock said during a radio appearance in London Tuesday. “We’re not 100 percent sure because some of the people who got it didn’t test positive,” said Hancock.
The NYC Health Department told NBC New York that since Kawasaki is not a disease that must be reported to them, they can’t say if there’s been a spike in the number of pediatric cases here.
At a news conference on Wednesday morning, Mayor de Blasio indicated he might be interested in doing more surveillance.
“I am very concerned. I think we’ve got to figure out how to understand it better and if it is something to be tracked,” de Blasio said. But several hours later the city's Department of Health and Mental Hygiene said in a statement “Kawasaki Syndrome is a rare condition and we are investigating. We do not yet have results to share at this time.”
Infectious disease doctors say it is not uncommon for Kawasaki Disease to be triggered by a viral infection.
Symptoms can include prolonged fever, red eyes, gastrointestinal distress, swollen hands or feet. If untreated, Kawasaki can cause fatal heart damage.
In response to an inquiry from NBC New York, the Centers for Disease Control said Wednesday that the organization is “looking closely at data and published scientific reports about the presentation and course of illness in children as they become available.”
“It’s important that doctors recognize there can be an association between COVID and Kawasaki but I don’t want to add another layer of fear and irrational emotion to this disease,” said Dr. Jennifer Lighter of NYU Langone, who declined to discuss any specific cases at her hospital. “But I still want people to take into consideration that COVID in children is a much less severe disease than it can be in adults.”
In NYC, 273 children have been hospitalized with confirmed COVID-19. City officials believe seven have died from the coronavirus.
A spokesman for Mount Sinai Hospital declined to comment on any recent pediatric patients experiencing inflammatory symptoms.
