Rare syndrome affecting children may be associated with COVID-19

Editor's note:  For the latest news on COVID-19, visit https://www.aappublications.org/news/2020/01/28/coronavirus.

Most children do not get very sick from COVID-19. However, some children have developed a rare condition that may be associated with COVID-19 called multisystem inflammatory syndrome in children (MIS-C). MIS-C causes inflammation of many or all of the internal organs, such as the intestines, heart, lungs and kidneys.

The American Academy of Pediatrics is working with a broad range of pediatric infectious diseases specialists to better understand this rare syndrome. It is not yet known who is most at risk of developing MIS-C or how it is connected to COVID-19. Here is what we know so far.

Children with MIS-C have a fever and evidence from laboratory tests of inflammation in their body. Other symptoms are abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes and feeling extra tired, according to the Centers for Disease Control and Prevention. Life-threatening symptoms may include trouble breathing, pain or pressure in the chest that does not go away, confusion, being unable to wake up or stay awake, bluish lips or face, or severe abdominal pain. Call 911 or go to the emergency department if your child has these symptoms.

Children with symptoms of MIS-C likely were exposed to someone with COVID-19 in the past four weeks or had a positive test for current or recent SARS-CoV-2 infection, the virus that causes COVID-19.

Most children who have MIS-C need to be treated in the hospital, and most get better with medical care. Treatment may include medicines to reduce inflammation, giving fluids and providing support to the lungs and heart. Blood tests, a chest X-ray, heart ultrasound (echocardiogram) and abdominal ultrasound also may be used to check for inflammation and other problems.

Fortunately, most children infected with SARS-CoV2 do not have symptoms or have mild infections. However, they still can spread infections to others. Parents should remind children to take these steps to avoid getting sick:

• Wash hands often with soap and water for 20 seconds or use alcohol-based hand sanitizer.
• Avoid people who are sick.
• Keep at least 6 feet away from people outside your household.
• Wear cloth face coverings (if child is 2 years or older).

Finally, it is important for children to be immunized on time, according to the recommended schedule. Pediatric practices have created safe environments to see children and are prepared to see well and sick children. Parents are encouraged to call their pediatrician with questions or concerns.