Friday, May 29, 2020

JPIDS: Multisystem Inflammatory Syndrome in Children : A Case Series

Credit NIAID


Just over a month ago we saw the first alert go out - issued by the UK's NHS - on a newly recognized inflammatory syndrome in children which as been tentatively and temporally linked to COVID-19 (see PICS: NHS Alert On Possible Severe Pediatric COVID-19 Complication). 

Since then we've seen a barrage of reports - both in the UK and in the United States - including:
RCPCH: Case Definition For Pediatric Inflammatory Syndrome
NYC HAN Alert On Pediatric Multi-System Inflammatory Syndrome
New York DOH Advisory On Pediatric Multi-System Inflammatory Syndrome
Update On Pediatric Multi-System Inflammatory Syndrome 
Two weeks ago the CDC released their own HAN Advisory (see CDC HAN: Multisystem Inflammatory Syndrome In Children (MIS-C)), instructing doctors across the nation on how recognize and report the condition, and 10 days ago the CDC held a COCA Call on Multisystem Inflammatory Syndrome in Children (MIS-C).
Around the same time the World Health Organization issued a Scientific Brief: Multisystem Inflammatory Syndrome in Children & Adolescents with COVID-19with a new case definition, and instructions for reporting cases.
As fresh reports come in from around the country of more children diagnosed with this poorly understood syndrome (see herehere, and here), we are beginning  to see some published studies, including:
Septic shock presentation in adolescents with COVID-19
Multisystem inflammatory syndrome with features of Atypical Kawasaki disease during COVID-19 pandemic: Report of a case from India
Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic

Yesterday the Journal of the Pediatric Infectious Diseases Society published a case study of six children presenting with this syndrome; 5 female, 1 male - ages 5 to 14 - all critically ill.
While the popular perception has been that children are generally spared from serious illness with COVID-19 - and statistically speaking, that is true - for some small fraction of kids this infection can produce dramatic, and truly life threatening complications. 
I've only posted the abstract, so follow the link to read the full case study. 
Multisystem Inflammatory Syndrome in Children during the COVID-19 pandemic: a case series

Kathleen Chiotos, MD, MSCE, Hamid Bassiri, MD, PhD, Edward M Behrens, MD, Allison M Blatz, MD, Joyce Chang, MD, Caroline Diorio, MD, Julie C Fitzgerald, MD, MSCE, Alexis Topjian, MD, MSCE, Audrey R Odom John, MD, PhD
Journal of the Pediatric Infectious Diseases Society, piaa069, 28 May 2020 Article history

We present a series of six critically ill children with Multisystem Inflammatory Syndrome in Children (MIS-C). Key findings of this syndrome include fever, diarrhea, shock, and variable presence of rash, conjunctivitis, extremity edema, and mucous membrane changes.
          (Continue . . . )