Pediatric patients presenting with compatible symptoms should undergo SARS-CoV-2 testing
THURSDAY, May 7, 2020 (HealthDay News) — The New York State Department of Health issued an advisory on May 6 regarding cases of pediatric multisystem inflammatory syndrome potentially associated with COVID-19.
As of May 5, 2020, 64 suspected pediatric cases compatible with COVID-19-associated multisystem inflammatory syndrome have been reported in children in New York state hospitals. The syndrome includes features that overlap with Kawasaki disease and toxic shock syndrome, such as elevated inflammatory markers, fever and abdominal symptoms, and rash. Myocarditis and other cardiovascular changes may be seen, and some patients may have evidence of single or multiorgan dysfunction or have developed cardiogenic or vasogenic shock, requiring intensive care. The syndrome may occur days to weeks after acute COVID-19 illness.
Early recognition by pediatricians is essential, with prompt referral to an inpatient specialist, including critical care. Pediatricians and specialists should consider this syndrome, especially when other microbial etiologies have been excluded. Pediatricians and specialists should obtain information relating to a child’s recent history of illness with COVID-19 or close contact with individuals known to have COVID-19. Most patients presenting with this syndrome have tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on diagnostic or molecular testing or on serological testing for corresponding antibodies.
In patients who are younger than 21 years of age, hospitals must report cases of pediatric multisystem inflammatory syndrome potentially associated with COVID-19 immediately through the Health Emergency Response Data System. For pediatric patients presenting with compatible symptoms, hospitals must perform a diagnostic and serologic test to detect the presence of SARS-CoV-2.
In a May 6 statement, the American Heart Association noted a small number of pediatric patients developed this more serious inflammatory syndrome with COVID-19 in Europe and recently the United States. “COVID-19 infection leading to critical illness in children remains very infrequent,” the AHA wrote in the statement.
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