Massachusetts hospitals are seeing a small number of cases of a rare pediatric inflammatory disease afflicting children that is possibly related to COVID-19.
The condition’s currently being referred to as “Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19,” Boston Children’s Hospital said in a recent posting to its website by the communications staff. The article noted that not all children with the syndrome tested positive for COVID-19.
“This is very rare,” said Dr. Jeffrey Burns, chief of critical care at Boston Children’s, in a recent interview with WBZ-TV. " ... The thing that a parent should look for is persistent fever. If your child has a persistent fever, that’s a reason to call your pediatrician."
Burns also said in last week’s Boston Children’s posting that the best evidence to date shows “children rarely become critically ill” from the syndrome, and that [our] major objective is to alert clinicians to this clinical presentation, to ensure that these children get treated by pediatric specialists who pursue the appropriate clinical work-up, and to see that they are enrolled in integrated data registries and clinical trials that will promote evidence-based care and a better understanding of this disorder.”
Dr. Demetre C. Daskalakis, deputy commissioner of the New York City Health Department’s Division of Disease Control, wrote in a May 4 advisory that the syndrome is characterized by “persistent fever and features of Kawasaki disease and/or toxic shock syndrome” and that “abdominal symptoms [are] common.”
As of Wednesday morning, Boston Children’s Hospital had seen six patients “who fall under” the syndrome, with two currently in the hospital, a spokeswoman said. Neither of those patients were in the ICU.
New York Governor Andrew Cuomo said Tuesday that his state is now investigating about 100 cases of the syndrome. Three children in New York have died, and Cuomo advised all hospitals to prioritize COVID-19 testing for children presenting with symptoms.
Baystate Children’s Hospital in Springfield has also seen “a few children” presenting with the syndrome, according to Dr. Donna Fisher, the hospital’s Infectious Diseases chief.
“This is a rare event in the state compared to New York. Locally, we have seen only a very few children with what is being described as a multi-system inflammatory syndrome,” Fisher said Tuesday in a statement.
A Baystate spokesman said Wednesday morning that he had no additional information.
In his May 4 advisory, Daskalakis said cases may require ICU admission for cardiac or respiratory support.
He wrote that the New York City Health Department identified 15 patients between the ages of 2 and 15 who were hospitalized with illnesses compatible with the syndrome from April 17 to May 1.
“All patients had subjective or measured fever and more than half reported rash, abdominal pain, vomiting, or diarrhea,” he wrote. “Respiratory symptoms were reported in less than half of these patients. Polymerase chain reaction (PCR) testing for SARS-CoV-2 has been positive (4), negative (10), and initially indeterminate and then negative (1).”
Daskalakis wrote that more than half the reported patients needed blood pressure support and five required ventilators. He urged pediatricians to take immediate action if they suspect patients have the syndrome.
Pediatricians, Daskalakis wrote, should “immediately refer patients to a specialist in pediatric infectious disease, rheumatology, and/or critical care, as indicated."
Material from the Associated Press was used in this report. Deanna Pan of the Globe Staff also contributed.