Officials said on Wednesday that the number of children who have been hospitalized in New York City with symptoms consistent with a rare disease possibly linked to the coronavirus has nearly quadrupled to 64. Health officials said the illness has features of Kawasaki disease, a serious illness previously noted in children with COVID-19 in the United Kingdom.
“A pediatric multi-system inflammatory syndrome, recently reported by authorities in the United Kingdom, is also being observed among children and young adults in New York City and elsewhere in the United States,” said Dr. Demetre Daskalakis, deputy commissioner of the New York City Health Department’s Division of Disease Control, in a public letter to colleagues this week.
According to Daskalakis, symptoms vary among the children depending on which organ system is affected, but “include features of Kawasaki disease or features of shock.” All of the children experienced a persistent fever, more than half reported rash, abdominal pain, vomiting or diarrhea, and less than half experienced respiratory symptoms. He added, however, that “the full spectrum of disease is not yet known.”
Kawasaki disease is associated with fever, skin rashes, and swelling of glands, and in severe cases, it can inflame blood vessels within the heart.
Dr. Dyan Hes, a pediatrician in New York City, told CBS News last week that she was “not surprised” by the U.K. report showing a possible link between COVID-19 and Kawasaki. According to Hes, children can sometimes develop the disease after a bout with the common cold, which is caused by a different variety of bug in the coronavirus family.
She added that Kawasaki could pop up “weeks to months later” after experiencing some kind of viral infection or “multiple viral infections.”
The cases reported in New York involved children who were hospitalized between April 17 and May 1 with “illnesses compatible with” a form of Kawasaki or shock, according to the New York City Health Department. More than half of the children required blood pressure support, and five required mechanical ventilation.
Those who were admitted to pediatric intensive care units required cardiac and/or respiratory support, according to the health department.
On Tuesday, it was reported that four of the 15 children tested positive for the coronavirus. Ten tested negative, and one was initially indeterminate and then negative. Serology testing showed that six patients with negative results had coronavirus antibodies in their blood, suggesting they had been previously infected.
Regardless of a coronavirus test result, the health department has urged doctors with patients under 21 years old who have symptoms consistent with Kawasaki to immediately report those suspected cases to the health department. Doctors are also instructed to immediately refer such patients to a “specialist in pediatric infectious disease, rheumatology, and/or critical care.”
Only severe cases may have been recognized so far, according to the health department. Daskalakis wrote that “early diagnosis and treatment of patients meeting full or partial criteria for Kawasaki disease is critical to preventing end-organ damage and other long-term complications.”
“We are learning that even though children are by and large mildly affected when it comes to COVID-19 that there can be situations that they are more severely affected,” New York City Health Commissioner Dr. Oxiris Barbot said Tuesday. “And thank God in this situation we haven’t had any children who have died with this Kawasaki or Kawasaki-like illness.”
