COVID-19 and kids

Each day, we’re learning more and more about the COVID-19 virus. While previously, it was believed that children were largely unaffected, recent cases coming out of Europe, New York and others parts of the U.S. show a connection between the virus and kids presenting with pediatric multisystem inflammatory syndrome, which resembles Kawasaki disease.  

Sherman Alter, MD, chief of infectious disease at Dayton Children’s, shares what we know about this condition, symptoms to look for and how the hospital is prepared to treat kids that present with the illness.  

What is this “mystery illness” that seems to be related to kids and COVID-19? 

We’ve seen that COVID-19 tends to be less severe and sometimes does not present any symptoms at all in children. This newly recognized condition is relatively uncommon. In fact, there are less than a couple hundred cases all over the world. 

The disease seems to be occurring in most kids after they’ve had coronavirus infection and looks very similar to a condition we’ve known for a while called Kawasaki disease. The entire illness might be a hyper-inflammatory response to the COVID-19 virus. A post-infection syndrome that needs to be cared for. 

What is Kawasaki Disease? 

Kawasaki disease is an illness that causes inflammation (swelling and redness) in blood vessels throughout the body. The condition most often affects kids younger than 5 years old. When symptoms are noticed early and treated, kids with Kawasaki disease begin to feel better within a few days. Children with pediatric multisystem inflammatory syndrome frequently present with signs and symptoms suggestive of Kawasaki disease.  

What are the symptoms of pediatric multisystem inflammatory syndrome? 

Children with the condition generally present with a high fever for four or more days combined with other symptoms that may include:  

• red ("bloodshot") eyes 

• a pink rash all over the body 

• a "strawberry" tongue (white coating with red bumps on the tongue) or red, cracked lips. 

• swollen palms of the hands and soles of the feet with a purple-red color 

• swollen lymph glands in the neck 

• Abdominal pain without another explanation 

Kawasaki disease typically appears in kids under the age of 5, but we’re now seeing older kids present with these symptoms.  

What should I do if my child develops these symptoms? 

If your child has any of these symptoms, it’s best to call their pediatrician, talk it over with them and see if you need to come into the office. 

How do you treat kids that present with these symptoms? 

We know how to manage Kawasaki disease. We have the medications that we need and we even have some extra medications that we don’t routinely use, but we could use. We have a pediatric intensive care unit, and have the subspecialty support to care for these kids, including critical care, rheumatology, cardiology, infectious disease and pulmonary.  

We have all the support, all the medication and a critical care unit that’s ready to go if we need to treat these patients. 

How soon does this develop after contracting COVID-19? 

When these kids are tested for COVID-19, almost all of them negative. They’ve gotten over the initial infection and developed this complication. But, if you order the antibody test, the blood test, most of these kids have antibodies, which proves they had a coronavirus infection, likely two to four or more weeks prior.  

What can we do to prevent this condition in my child? 

It’s important to remember that this is relatively uncommon. However, it’s important to keep doing what we’re doing to prevent the spread of infection—good hand hygiene, social distancing, etc. If you have any concern about your child, you should check with your pediatrician.