What parents need to know about an inflammatory syndrome linked to novel coronavirus

A child's fever may have a new underlying cause.

Cases of COVID-19-related inflammation throughout the bodies of children have led physicians to urge parents not to disregard a temperature spike.

Multisystem inflammatory syndrome in children is a condition in which organs including the heart, lungs and kidneys become swollen.

Many children with MIS-C had the virus that causes COVID-19 or were near someone with the novel coronavirus, the Centers for Disease Control and Prevention has reported.

Every major children's hospital in Texas has diagnosed patients with the syndrome, physicians familiar with the cases said.

Since the novel coronavirus began to emerge, five children have been treated for MIS-C at Cook Children's Medical Center in Fort Worth. All of the patients have returned home, a hospital spokeswoman said.

Asked for the number of patients that Children's Medical Center Dallas and Children's Medical Center Plano have treated for Multisystem Inflammatory Syndrome, a representative of the hospitals did not answer directly.

"Since the CDC issued its advisory about multi-system inflammatory syndrome, we are still thoroughly investigating any potential cases of this syndrome and continuing to monitor for symptoms in our patients," the hospitals' parent system, Children's Health, said.

A Tarrant County Public Health spokesman said the department was aware of two syndrome cases.

Based on the case numbers, the risk appears to be extraordinarily low, but much about the syndrome remains unclear.

Children have died from MIS-C, the CDC said, but most patients with the condition have improved with medical care.

A parent wary of doctors' offices who delays assessment of a child's fever is among the concerns of physicians treating the syndrome, said Dr. Priya Bui, a pediatrician and associate professor at the University of North Texas Health Science Center in Fort Worth.

Telemedicine is a strong alternative for patients to get care, especially for people who fear being inside a medical facility during the pandemic, Bui said.

Testing, however, often requires an ultrasound, X-ray and blood analysis.

Studies of factors that put children at greater risk are incomplete. There is an early indication that children of Afro-Caribbean descent are at increased risk, Bui said, but much remains unknown.

The syndrome is "too new to know for sure," about risk elements, said Dr. Nicholas Rister, an Cook infectious diseases physician.

Four of the patients treated at Cook are between 6 and 14 years old. Cook did not release the age of the fifth patient. At least one syndrome patient was treated in the hospital's pediatric intensive care unit.

As of Sunday, Tarrant County has had 8,955 confirmed COVID-19 cases, including 208 deaths and about 4,100 recoveries.

The children with the inflammatory syndrome presented with symptoms that resembled a severe case of Kawasaki disease, Rister said. Kawasaki disease is an illness that creates inflammation in blood vessels that is thought to follow infections after they have otherwise resolved.

The patients arrived at Cook Children's following exposure to COVID-19 and had symptoms including fever, abdominal pain and outward evidence of inflammation including diffuse rashes, conjunctivitis and swelling. In the more severe cases, there was evidence of multi-organ dysfunction including respiratory distress, low blood pressures, liver and kidney damage, and altered mental status.

"Of particular concern to us is inflammation of the heart and surrounding major blood vessels which is also seen in Kawasaki's disease. We have seen this same thing in several of these COVID inflammatory disease patients," Rister said in a May statement. "Minimizing the degree of inflammation in these children, while providing supportive care for any organ damage, has been a key component of treatment."

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