More cases of the mysterious coronavirus syndrome affecting kids expected in coming weeks

A rise in the mystery inflammatory syndrome that seems to be affecting children following a bout with Covid-19 is to be expected soon, said doctors on Wednesday. Dr. Jeffrey Burns, a critical care specialist at Boston Children's Hospital, said that the condition—known as multisystem inflammatory syndrome in children—appears to be a post-viral syndrome. Burns, who has been coordinating a global group of doctors comparing their insights on the condition, revealed that, as of now, experts believe the illness is the result of the patient's immune response to the novel coronavirus.

"This multisystem inflammatory syndrome is not directly caused by the virus. The leading hypothesis is that it is due to the immune response of the patient," Burns told CNN. At least 150 cases of pediatric multisystem inflammatory syndrome in the United States are being investigated by doctors, of which most were reported in New York. However, there's a good chance this number is higher as hospitals and clinics in at least 18 states and Washington DC are looking into more suspected cases. Dr. Ngozi Ezike, director of the Illinois Department of Public Health, said that it's a complicated disorder.

"It's a spectrum of disorders, and so in some cases, you'll have the individual have coronary artery involvement. Sometimes they don't," he said during a news conference. Symptoms of the syndrome include persistent fever, inflammation, and poor function in organs such as the kidneys or heart. Affected children might also show evidence of blood vessel inflammation, such as red eyes, a bright red tongue, and cracked lips, explained Dr. Moshe Arditi, a pediatric infectious diseases expert at Cedars-Sinai Medical Center in Los Angeles. 

After British doctors last month raised the alarm about a rare and mysterious illness affecting children, the Royal College of Paediatrics said on Thursday that between 75 and 100 children in Britain had been affected. Instances of the syndrome have also been reported in Italy. Reports from Europe and from several cities in the United States show a link between the affected children despite not all of them testing positive for the novel coronavirus. "There seems to be delayed responses to Covid infections in these kids," said Arditi.

Although pediatric multisystem inflammatory syndrome is a rare condition, Burns expects more cases in the coming weeks as the number of Covid-19 cases increases. Rare consequences of viral infections—such as the one we're fighting now—occur more often when millions of people are infected. "We can expect that each of the epicenters will see clusters of these emerging roughly four to six weeks later," said Burns. "It makes sense that it emerged in New York first because New York had the largest and most severe outbreak (of Covid-19), followed by New Jersey and, unfortunately, Boston."

Although a few affected children have died, most aren't seriously affected by the syndrome and don't even require treatment in the intensive care unit, he said. "We do have proven treatments (such as blood thinners and immune modulators) that we can use and are using," Burns revealed. Meanwhile, a CDC spokesman said that the Centers for Disease Control and Prevention is preparing a Health Alert Network notification to send to doctors across the country. The World Health Organization is also working to define the syndrome so as to alert doctors and educate them on what to look for and how to treat it, said Burns.

"This new entity has some similarities to Kawasaki disease. But there are a lot more features that are consistent with toxic shock syndrome, such as multi-organ system involvement and severe abdominal involvement with diarrhea," said Arditi. Studying the syndrome could help determine why children are so much less likely to be severely affected by Covid-19 than adults are. "Understanding the child's immune response could be a key to vaccine development and could also be a key to therapy for adults to understand why children are able to fight (Covid-19) off so well," said Burns.