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Why does COVID-19 appear to cause inflammatory response in some children?

While only a small percentage of children infected with the novel coronavirus become seriously ill, researchers are now learning about a potentially dangerous syndrome in young people apparently caused by the virus. In more than 100 cases in New York and 60 in Europe, doctors have seen an inflammatory response similar to Kawasaki disease. William Brangham talks to pediatrician Dr. Jane Newburger.

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  • Judy Woodruff:

    While just a small percentage of the children infected with this coronavirus get seriously ill, researchers are now learning about a new potentially dangerous syndrome in young people that seems to be caused by the virus.

    In more than 100 cases in New York and 60-plus across Europe, young people have developed an inflammatory response similar to what's known as Kawasaki disease. It's led to concerns that we still don't fully understand the full impact that COVID is having on young people.

    William Brangham gets some answers about what is known.

  • William Brangham:

    For more on this syndrome, I talked with someone who is both seeing and treating patients with this syndrome.

    Dr. Jane Newburger is a pediatric cardiologist at Boston Children's Hospital, and she's also a member of the Young Hearts Council of The American Heart Association.

    Dr. Newburger, thank you very much for being here.

    First off, could you just help us understand, what is this syndrome that you're seeing in your young patients?

  • Jane Newburger:

    So, this new Pediatric Multisystem Inflammatory Syndrome strikes children…

  • William Brangham:

    That's the technical term for it, you were saying.

  • Jane Newburger:

    Yes.

    It strikes individuals who are under 21 years of age. And it's manifested by either an extreme inflammatory response and by at least one organ, often two or more, that are not functioning properly because of the inflammatory milieu.

    To have it, you can't have another explanation than your recent exposure to COVID-19. So you must have either current evidence of COVID-19 from a nasal swab for SARS-CoV-2 or evidence much more often of a recent infection because you were antibody positive, or else you need to have been exposed closely to somebody who had COVID-19 in the past four weeks.

  • William Brangham:

    I see.

    Do we know why coronavirus is causing this syndrome?

  • Jane Newburger:

    We think it's causing this syndrome as a kind of immunologic reaction.

    In other words, it doesn't seem to be related to an acute infection with COVID — with SARS-CoV-2, but much more related to the body's immune response to having been exposed to that virus.

    And so one has a tremendous inflammatory response to the trigger, really, that is the virus.

  • William Brangham:

    And what is the outcome, generally speaking, for the kids, for the young people who develop this syndrome?

  • Jane Newburger:

    Well, we think parents can be very optimistic if a child does develop this syndrome.

    With careful — careful support and the right medications, the majority of children seem to be recovering very well. It is a new wave of illness that we still are characterizing. So we don't — we don't have big statistics or reliable numbers that we can give people yet.

    But, very quickly, people are gathering their cases, and we're hoping that every child or teen who has this illness is logged into a registry of some sort, so that we can provide very quantitative information in the future.

  • William Brangham:

    Can you help us put this in perspective?

    I mean, my just quick back-of-the-envelope calculation is that this is affecting a relatively small number of the children who we believe who have been exposed to SARS-CoV-2. So help us weigh — for the parents who might be out there hearing about this, seeing this in the news, how worried should parents be, given how few cases we seem to see of this?

  • Jane Newburger:

    This is a very rare reaction or phenomenon compared to all the children who've been exposed to SARS-CoV-2.

    I wouldn't be extremely worried as a parent. I think you can be reassured that the vast majority of children have either no symptoms or very mild symptoms in response to the virus. So, very few children are having this new syndrome.

  • William Brangham:

    Let's assume that there are parents who do worry their child might have been exposed to the virus.

    Are there symptoms particularly of this syndrome that they ought to be on the lookout for?

  • Jane Newburger:

    Yes.

    So if a child has fever and seems inflamed, with a rash, red eyes, red lips, any signs of what we call Kawasaki disease, and if they have G.I. symptoms as well, which seem to be very, very common, diarrhea, vomiting, abdominal pain, they should be in contact with their primary caregiver or their pediatrician.

    If the child really seems sick, in a sense — the way that a parent's sixth sense tells you, and they don't seem responsive or their color doesn't seem right, then they should go to a hospital, if they're worried.

  • William Brangham:

    This is all some very, very helpful advice amidst a lot of confusion and nervousness and fright on a lot of parents' part.

    Dr. Jane Newburger, thank you very much for being here.

  • Jane Newburger:

    Thank you.

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