SRPINGFIELD — Baystate Children’s Hospital is asking pediatricians to be “on the lookout” for patients with symptoms associated with an acute inflammatory condition that has been linked to COVID-19.
The condition, Pediatric Inflammatory Multisystem Syndrome, or PIMS, is considered rare, but potentially fatal. Several dozen cases have been reported in New York in children who tested positive for COVID-19 or its antibodies.
“We are alerting area pediatricians to be on the lookout for patients with the following symptoms – persistent fever, abdominal pain including diarrhea or vomiting, rash or changes in skin color, difficulty breathing, confusion and sleepiness,” said Dr. Donna Fisher, chief of infectious diseases for Baystate Children’s Hospital.
Fisher said earlier this week that Baystate has “seen only a very few children” with this syndrome that was first reported in Europe and that she called “a rare occurrence.” She noted many of the reported cases to date in this country have been “centered in New York,” where it has killed three children and where the largest number of adult COVID-19 have occurred.
Fisher said PIMS is “believed to be a condition associated with COVID-19.”
Cases in Europe were seen in children who tested positive for COVID-19 as well as those who did not and in some children with a vascular condition called Kawasaki disease.
“It has been compared to other rare childhood illnesses such as Kawasaki disease or toxic shock syndrome, but in relation to COVID-19 it is believed to be a somewhat different and separate condition until more is known about it,” said Fisher of PIMS.
“While a serious illness, it is a rare occurrence, and compared to adults, most children are not affected by COVID-19 and those reporting with serious illness still remain rare. Most cases, reportedly over 100, have been centered in New York, where we have seen the greatest cases of COVID-19 in adults, with cases now being reported in Massachusetts, Connecticut and some other states.”
There is no medically approved treatment for SARS-CoV-2, the novel coronavirus that has caused the COVID-19 pandemic, and more continues to be learned about its impact on the human immune system with its spread beyond China where it was first identified earlier this year.
The respiratory illness can cause severe lung damage and inflammation in adults, but was thought to mostly spare children though Chinese scientists warned early their studies on its impact on children were limited.
Fisher is not surprised by the new inflammatory syndrome as much remains unknown about SARS-CoV-2, though efforts to test for it have increased in the United States to both identify where cases are as well as complications of the virus. The fact that it transmits easily when an infected person is in close proximity to others has led to lock downs in most countries because of widespread community transmission.
“Given the unpredictability about this novel coronavirus, and an increase in testing, reports about this new complication are not entirely unexpected,” Fisher said.
“As many states prepare to open up, an increase in cases of PIMS remains a possibility. Up until now, children shut-in at home may have been exposed to COVID-19 and its complications from parents who are essential workers bringing the virus home with them.”
Fisher said both babies and children have been hospitalized for COVID-19 at Baystate Children’s Hospital.
She added that the hospital sees “very few cases of Kawasaki disease, and it appears to be more prevalent in the spring.”
She described it as a fever-related illness that primarily affects “children under the age of 5.”
“It causes inflammation of the blood vessels and can lead to heart disease if not diagnosed and treated early on,” Fisher said.
“It is not fully understand what causes Kawasaki disease, but some theories relate it to genetics.”
She said that “traditional treatment for children with Kawasaki disease who are sick enough to be in the hospital, often in intensive care, is a course of gamma globulin, an immune protein infused through the vein.”
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