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More than a dozen cases of COVID-linked inflammatory syndrome found in local children

Nemours Children's Health System

As public officials weigh how to conduct school this fall, children are being held up as low risk for getting seriously sick from COVID-19. 

But some kids have suffered from a rare, mysterious syndrome linked to the virus—even in Delaware.

Nemours/A.I. duPont Hospital for Children (Nemours) has now seen 15 cases of a COVID-linked inflammatory syndrome in local children. Delaware Public Media reported in May the hospital had confirmed three cases at that point. 

Multisystem Inflammatory Syndrome in Children, or MIS-C, is thought to be a rare secondary immune response to coronavirus infection which can cause dangerous inflammation of body parts including the brain, heart or lungs. Symptoms include fever, abdominal pain and rash.

“We saw a sudden surge of cases for a couple of weeks in June— about four cases a week for a couple of weeks," said Dr. Deepika Thacker, pediatric cardiologist and in-patient medical director for cardiology at Nemours. “Thankfully that decreased and we haven’t seen a confirmed case for the past week.”

The patients treated at Nemours have ranged in age from 15 months to 16 years, the majority male. Five have been Delaware residents, and the rest from surrounding states. 

Thacker says a fever lasting on average three to four days has been a consistent marker. The majority of cases have also presented with gastrointestinal complaints, including nausea, vomiting, diarrhea or abdominal pain (one of the older female patients’ abdominal pain was so severe she had an appendectomy at a different hospital before being diagnosed with MIS-C at Nemours). About half of the patients experienced heart issues. 

Thacker says all the MIS-C patients treated at Nemours have responded well to treatment — which includes intravenous immunoglobulin, anticoagulants to prevent blood clotting, and steroids or high-dose aspirin depending on the severity of the case. 

“The younger children actually did very well,” said Thacker. “It’s our older children, more than 10 years old, who actually were the sickest of the group.”

Over the past few months, Nemours doctors have learned that older MIS-C patients can look well but deteriorate rapidly. Doctors have changed protocols accordingly. 

“Unless they’re really stable, we have started admitting them directly to the pediatric intensive care unit (ICU),” said Thacker. “Because we now know how to manage them, we are able to institute all these treatments within a matter of hours rather than days, so our children have had excellent outcomes.”

And the COVID-linked inflammatory syndrome remains rare. 

“Overall COVID infection in children is less common than adults, it’s less severe than adults,” said Thacker. “Even with this inflammatory syndrome, the numbers are still really small, and they’re all responding to treatment.”

Doctors still do not know why certain children develop MIS-C. NPR recently reported doctors are monitoring recovered MIS-C patients to watch for long-term complications. 

Nemours is sharing data about its cases with other pediatric health systems, the CDC and the state. 

Thacker says Nemours secured a grant to do COVID-19 antibody testing on patients diagnosed with similar conditions, such as Kawasaki disease, before the hospital started recognizing MIS-C cases earlier this year.  That testing will start next month.

Sophia Schmidt is a Delaware native. She comes to Delaware Public Media from NPR’s Weekend Edition in Washington, DC, where she produced arts, politics, science and culture interviews. She previously wrote about education and environment for The Berkshire Eagle in Pittsfield, MA. She graduated from Williams College, where she studied environmental policy and biology, and covered environmental events and local renewable energy for the college paper.
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