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Children Are Falling Ill With a Baffling Ailment Related to Covid-19 Children Are Falling Ill With a Baffling Ailment Related to Covid-19
(1 day later)
One child, 8 years old, arrived at a Long Island hospital near death last week. His brother, a boy scout, had begun performing chest compressions before the ambulance crew reached their home.One child, 8 years old, arrived at a Long Island hospital near death last week. His brother, a boy scout, had begun performing chest compressions before the ambulance crew reached their home.
In the past two days alone, the hospital, Cohen Children’s Medical Center, has admitted five critically ill patients — ages 4 to 12 — with an unusual sickness that appears to be somehow linked to Covid-19, the disease caused by coronavirus. In total, about 25 similarly ill children have been admitted there in recent weeks with symptoms ranging from reddened tongues to enlarged coronary arteries.In the past two days alone, the hospital, Cohen Children’s Medical Center, has admitted five critically ill patients — ages 4 to 12 — with an unusual sickness that appears to be somehow linked to Covid-19, the disease caused by coronavirus. In total, about 25 similarly ill children have been admitted there in recent weeks with symptoms ranging from reddened tongues to enlarged coronary arteries.
Since the coronavirus pandemic began, most infected children have not developed serious respiratory failure of the kind that has afflicted adults. But in recent weeks, a mysterious new syndrome has cropped up among children on Long Island, in New York City and in other hot spots around the country, in an indication that the risk to children may be greater than anticipated.Since the coronavirus pandemic began, most infected children have not developed serious respiratory failure of the kind that has afflicted adults. But in recent weeks, a mysterious new syndrome has cropped up among children on Long Island, in New York City and in other hot spots around the country, in an indication that the risk to children may be greater than anticipated.
The number of children in the United States showing signs of this new syndrome — which first was detected in Europe last month — is still small. None are known to have died, and many have responded well to treatment.The number of children in the United States showing signs of this new syndrome — which first was detected in Europe last month — is still small. None are known to have died, and many have responded well to treatment.
No solid data yet exists about how many children in the United States have fallen ill with what doctors are calling “pediatric multisystem inflammatory syndrome.”No solid data yet exists about how many children in the United States have fallen ill with what doctors are calling “pediatric multisystem inflammatory syndrome.”
“This is really only a disease that has been clear for two weeks now, so there is so much we’re trying to learn about this,” the chief of pediatric critical care at Cohen Children’s, Dr. James Schneider, said in an interview on Tuesday.“This is really only a disease that has been clear for two weeks now, so there is so much we’re trying to learn about this,” the chief of pediatric critical care at Cohen Children’s, Dr. James Schneider, said in an interview on Tuesday.
Doctors say this condition does not seem to be driven by the virus attacking the lungs, a hallmark of coronavirus infection in adults.Doctors say this condition does not seem to be driven by the virus attacking the lungs, a hallmark of coronavirus infection in adults.
While some of the children with this condition do end up with respiratory problems and a few have needed to be on ventilators, “it seems to be less a lung-specific disease,” said Dr. Steven Kernie, chief of pediatric critical care medicine at Columbia University and NewYork-Presbyterian Morgan Stanley Children’s Hospital, which has treated between 10 and 20 children with the condition, ranging from infants to older teenagers.While some of the children with this condition do end up with respiratory problems and a few have needed to be on ventilators, “it seems to be less a lung-specific disease,” said Dr. Steven Kernie, chief of pediatric critical care medicine at Columbia University and NewYork-Presbyterian Morgan Stanley Children’s Hospital, which has treated between 10 and 20 children with the condition, ranging from infants to older teenagers.
He said many of their symptoms — from rashes to redness of eyes to blood circulation problems — appear to be rooted in an “overall inflammatory response.”He said many of their symptoms — from rashes to redness of eyes to blood circulation problems — appear to be rooted in an “overall inflammatory response.”
In some patients the syndrome seems similar to a rare childhood illness called Kawasaki disease, which can lead to inflammation of the blood vessels, especially the coronary arteries.In some patients the syndrome seems similar to a rare childhood illness called Kawasaki disease, which can lead to inflammation of the blood vessels, especially the coronary arteries.
The symptoms of Kawasaki disease often start with a fever and a rash, but when undiagnosed and untreated, the illness can lead to serious heart conditions, such as coronary aneurysms. The disease, which generally afflicts patients 6 months to about 6 years old, is considered rare in the United States.The symptoms of Kawasaki disease often start with a fever and a rash, but when undiagnosed and untreated, the illness can lead to serious heart conditions, such as coronary aneurysms. The disease, which generally afflicts patients 6 months to about 6 years old, is considered rare in the United States.
But Dr. Kernie said it was important to distinguish between this coronavirus-related condition and Kawasaki disease.But Dr. Kernie said it was important to distinguish between this coronavirus-related condition and Kawasaki disease.
While some of the symptoms are similar, Dr. Kernie said, including fever, abdominal pain and sometimes a raised rash, there appear to be differences in how the coronavirus-related condition affects the heart.While some of the symptoms are similar, Dr. Kernie said, including fever, abdominal pain and sometimes a raised rash, there appear to be differences in how the coronavirus-related condition affects the heart.
While shock is a rare complication of Kawasaki disease, in the recent wave of coronavirus-related cases, he said, many of the children are in toxic shock with very low blood pressure and an inability of the blood to effectively circulate oxygen and nutrients to the body’s organs.While shock is a rare complication of Kawasaki disease, in the recent wave of coronavirus-related cases, he said, many of the children are in toxic shock with very low blood pressure and an inability of the blood to effectively circulate oxygen and nutrients to the body’s organs.
On Monday night, the New York City Health Department issued a bulletin, asking doctors to report any cases of the syndrome. The bulletin said the health authorities in the city knew of 15 such cases, involving patients age 2 to 15, who have been in intensive care units since April 17.On Monday night, the New York City Health Department issued a bulletin, asking doctors to report any cases of the syndrome. The bulletin said the health authorities in the city knew of 15 such cases, involving patients age 2 to 15, who have been in intensive care units since April 17.
But interviews with doctors in New York City and on Long Island suggest that at least 50 children have been treated for the syndrome, not all in intensive care.But interviews with doctors in New York City and on Long Island suggest that at least 50 children have been treated for the syndrome, not all in intensive care.
“I would say so far we have seen 13 patients,” Dr. Nadine Choueiter of the Children’s Hospital at Montefiore in the Bronx said of the children treated for the syndrome at just her hospital.“I would say so far we have seen 13 patients,” Dr. Nadine Choueiter of the Children’s Hospital at Montefiore in the Bronx said of the children treated for the syndrome at just her hospital.
Still, doctors were reluctant to speculate how widespread it might be across the city. “That is the question we are constantly thinking about, and I don’t think we know the answer,” Dr. Choueiter said.Still, doctors were reluctant to speculate how widespread it might be across the city. “That is the question we are constantly thinking about, and I don’t think we know the answer,” Dr. Choueiter said.
In Richmond Hill, Queens, Jayden Hardowar, 8, initially had only a mild fever, starting on April 23, his father, Roup Hardowar, said.In Richmond Hill, Queens, Jayden Hardowar, 8, initially had only a mild fever, starting on April 23, his father, Roup Hardowar, said.
But several days later, Jayden started to grow very weak and listless. On April 29, he was lying in bed watching a Pokemon TV episode. “Mommy,” he cried out, before he stopped breathing. His face started turning purple. His 15-year-old brother, a boy scout, began performing chest compressions, stopping only when the ambulance arrived, his father said.But several days later, Jayden started to grow very weak and listless. On April 29, he was lying in bed watching a Pokemon TV episode. “Mommy,” he cried out, before he stopped breathing. His face started turning purple. His 15-year-old brother, a boy scout, began performing chest compressions, stopping only when the ambulance arrived, his father said.
At Cohen’s Hospital, in New Hyde Park, Jayden was put on a mechanical ventilator for three days before he began to improve. Although Jayden tested negative for the coronavirus, he tested positive for antibodies, suggesting he might have been infected with the virus in recent weeks or months, his father said.At Cohen’s Hospital, in New Hyde Park, Jayden was put on a mechanical ventilator for three days before he began to improve. Although Jayden tested negative for the coronavirus, he tested positive for antibodies, suggesting he might have been infected with the virus in recent weeks or months, his father said.
In recent days, Jayden has begun to open his eyes and smile or cry at his parents during video chats arranged by a nurse. “Last night he said, ‘I love you, Mommy,’” his father recounted on Tuesday.In recent days, Jayden has begun to open his eyes and smile or cry at his parents during video chats arranged by a nurse. “Last night he said, ‘I love you, Mommy,’” his father recounted on Tuesday.
Jayden is one of 11 children in the intensive care unit at Cohen Children’s deemed to have the syndrome, doctors there said.Jayden is one of 11 children in the intensive care unit at Cohen Children’s deemed to have the syndrome, doctors there said.
Similar cases have appeared elsewhere in the country, too.Similar cases have appeared elsewhere in the country, too.
Juliet Daly, a healthy 12-year-old from Covington, La., woke up on April 3 with such sharp pains in her stomach that she had trouble moving. “I spent one hour in bed trying, attempting to get up, and I spent half an hour going down the stairs,” Juliet said in an interview on Tuesday.Juliet Daly, a healthy 12-year-old from Covington, La., woke up on April 3 with such sharp pains in her stomach that she had trouble moving. “I spent one hour in bed trying, attempting to get up, and I spent half an hour going down the stairs,” Juliet said in an interview on Tuesday.
Updated June 1, 2020 Updated June 2, 2020
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
Over the weekend, she had a fever, and, she said, “I couldn’t eat and I couldn’t drink because I vomited everything up.” By Monday, “my arms were cold and my lips were blue,” she said.Over the weekend, she had a fever, and, she said, “I couldn’t eat and I couldn’t drink because I vomited everything up.” By Monday, “my arms were cold and my lips were blue,” she said.
She was so lethargic that “she kind of fell asleep in the bath,” said her father, Sean Daly.She was so lethargic that “she kind of fell asleep in the bath,” said her father, Sean Daly.
The family took Juliet to a nearby hospital, where they were told that she was experiencing an acute form of heart inflammation called fulminant myocarditis. Her heart rate was very low, and her heart was failing to pump blood.The family took Juliet to a nearby hospital, where they were told that she was experiencing an acute form of heart inflammation called fulminant myocarditis. Her heart rate was very low, and her heart was failing to pump blood.
The hospital decided to put Juliet on a ventilator and airlifted her to a medical center in New Orleans, about 40 miles south. During the intubation procedure, her heart stopped, and “she went into arrest for a little under two minutes,” Mr. Daly said. Later, on the helicopter, her heart stopped again and she needed to be revived by C.P.R., he said.The hospital decided to put Juliet on a ventilator and airlifted her to a medical center in New Orleans, about 40 miles south. During the intubation procedure, her heart stopped, and “she went into arrest for a little under two minutes,” Mr. Daly said. Later, on the helicopter, her heart stopped again and she needed to be revived by C.P.R., he said.
After nine days in the hospital, she returned home to her parents and two brothers. “I was able to walk around, but I was still wobbly,” she said. Now, Juliet, who likes to bike and do artwork, is feeling healthy.After nine days in the hospital, she returned home to her parents and two brothers. “I was able to walk around, but I was still wobbly,” she said. Now, Juliet, who likes to bike and do artwork, is feeling healthy.
Doctors in New York have noted that cases of the new syndrome began to appear a month or so after a surge of Covid-19 in the region. That timing suggests “it’s a post-infectious immune response to this,” said Dr. Leonard Krilov, chairman of pediatrics at NYU Winthrop Hospital in Mineola, N.Y.Doctors in New York have noted that cases of the new syndrome began to appear a month or so after a surge of Covid-19 in the region. That timing suggests “it’s a post-infectious immune response to this,” said Dr. Leonard Krilov, chairman of pediatrics at NYU Winthrop Hospital in Mineola, N.Y.
In some cases, the treatment for children with the new syndrome is straightforward and quick. Dr. Krilov recently treated a 4-year-old boy whose family had previously fallen ill with Covid-19. Weeks later, the boy had a high fever, a rash and kidney trouble. He was given one of the standard treatments for Kawasaki disease: intravenous immunoglobulin, a serum harvested from donated blood. Within a day his fever fell and kidneys returned to normal, Dr. Krilov said.In some cases, the treatment for children with the new syndrome is straightforward and quick. Dr. Krilov recently treated a 4-year-old boy whose family had previously fallen ill with Covid-19. Weeks later, the boy had a high fever, a rash and kidney trouble. He was given one of the standard treatments for Kawasaki disease: intravenous immunoglobulin, a serum harvested from donated blood. Within a day his fever fell and kidneys returned to normal, Dr. Krilov said.
Early research suggests that children are significantly less likely to become seriously ill with Covid-19 than adults. In New York City there have been 13,724 deaths of laboratory-confirmed Covid patients. Six have been 17 years old or younger, and all had underlying health conditions, according to city data.Early research suggests that children are significantly less likely to become seriously ill with Covid-19 than adults. In New York City there have been 13,724 deaths of laboratory-confirmed Covid patients. Six have been 17 years old or younger, and all had underlying health conditions, according to city data.
Doctors say that even though there is growing evidence that some healthy children are falling gravely ill with this new syndrome, they are still at far less risk from Covid-19 than adults.Doctors say that even though there is growing evidence that some healthy children are falling gravely ill with this new syndrome, they are still at far less risk from Covid-19 than adults.
“It’s just a different disease in adults,” said Dr. Jennifer Lighter, a pediatric infectious disease specialist at NYU Langone Medical Center, who treated one pediatric patient with the new syndrome last week.“It’s just a different disease in adults,” said Dr. Jennifer Lighter, a pediatric infectious disease specialist at NYU Langone Medical Center, who treated one pediatric patient with the new syndrome last week.
“It is very, very rare, and the children have been doing OK for the most part,” Dr. Lighter said of the new syndrome. “My patient is home and doing great.”“It is very, very rare, and the children have been doing OK for the most part,” Dr. Lighter said of the new syndrome. “My patient is home and doing great.”