CDC Issues Alert to Help Diagnose COVID-19 Related Illness in Kids

In recent weeks, there have been several cases cropping up all over the country about a mystery illness in children that could be related to COVID-19. Yesterday, the Center for Disease Control and Prevention (CDC) finally issued an alert on the illness, detailing the best practices for diagnosing it.

The CDC is calling the condition multisystem inflammatory syndrome in children (MIS-C) and in the alert lays out clearer diagnostic measures for healthcare professionals. The CDC also urges them to report any suspected cases—even if they also may fulfill part of the criteria for Kawasaki disease—to help officials learn more about MIS-C.

According to the CDC, an individual could have MIS-C if:

• A person younger than 21 years has a fever, lab evidence of inflammation and evidence of clinically severe illness that requires hospitalization with multisystem organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); and
• There is no alternative plausible diagnoses; and
• The person is positive for current or recent COVID-19 infection or has had exposure to it within the four weeks prior to the onset of their symptoms

The CDC explains that the fever should be at least 38 degrees for at least 24 hours or be a subjective fever that lasts 24 hours. The evidence of inflammation includes, but is not limited to, an “elevated C-reactive protein, erythrocyte sedimentation rate, fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase, or interleukin 6, elevated neutrophils, reduced lymphocytes and low albumin.”

The CDC’s alert did not include guidelines for treatment. However, according to Sean T. O’Leary, M.D., M.P.H., FAAP, a member of the AAP Committee on Infectious Diseases, intravenous immunoglobulin and supportive care have been common treatment approaches.

“I think right now the most important thing is supportive care in an intensive care setting,” he said in a news release from the AAP. “Pediatric intensive care doctors know how to take care of sick children very well and they know how to manage the things that are happening with these kids like low blood pressure and in some cases difficulty breathing, (and) in some cases kidney failure. They’re used to managing those types of conditions even though this is a new phenomenon.”

His advice for parents? Watch out for a persistent fever and contact their doctor if the child appears especially sick. “Parents really shouldn’t be afraid to take their child to their pediatrician if they’re worried they’re sick,” Dr. O’Leary stated in the release. “They should also, of course, make sure they are keeping up on their well-child care and their vaccinations. The diseases we prevent with vaccines are actually much more severe in children than COVID-19, so we want to make sure to protect children from those diseases.”

While scary and something to take seriously, Dr. O’Leary emphasizes that MIS-C seems to be rare and most cases COVID-19 in kids are mild or without any symptoms. He believes the syndrome may be a kind of “immune phenomenon,” as the cases “seem to appear about a month after a community is hit hard with COVID-19.”

Late in April, in the UK, there were increased reports of children suffering from a severe inflammatory syndrome that was similar to Kawasaki disease, an illness that usually affects kids aged 5 and younger and causes fever, rashes, swollen hands and feet and inflammation in the mouth, lips and throat. According to the CDC, these kids also tested positive for COVID-19 or had been exposed to it. In New York City, state health officials are looking into 102 similar cases as of May 12.

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