Minnesota health officials watching for 'extremely rare' syndrome possibly linked to COVID-19 in children

Health experts in Minnesota are keeping an eye out for the rare syndrome.
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A rare pediatric syndrome that has raised concern in New York has not been confirmed in any children in Minnesota, but state health officials are keeping an eye out for pediatric multi-system inflammatory syndrome. 

In New York City, the syndrome has been confirmed in 52 children and suspected in 10 others. Twenty-five of those children tested positive for COVID-19 and 22 others had antibodies, suggesting that they were previously infected with the novel coronavirus, according to CNBC. 

At this point, health officials say the syndrome, which is very rare, is possibly linked to COVID-19, but early indicators suggest that it's more likely an immune system reaction to the infection rather than something being caused by the virus itself. 

Bottom line: The syndrome is "extremely rare," according to Kris Ehresmann, director of the Infectious Disease Epidemiology, Prevention, and Control Division at the Minnesota Department of Health. 

"At this point, if your child has COVID-19 and then experiences additional concerning symptoms you should be reaching out to your health provider. It's an extremely rare complication. We are aware of it and we are setting up surveillance so we can be monitoring for this. But I do want to reiterate again, this is extremely rare."

Dr. Nipunie Rajapakse, a pediatric infectious diseases physician at the Mayo Clinic, says she first learned about the syndrome on April 26 through an alert issued by the National Health Service, which was tracking cases coming out of the United Kingdom. 

Symptoms have included fever, abdominal pain, gastrointestinal issues, rashes, conjunctivitis, and inflammation of mucus membranes. Some children have had very low blood pressure and presented with shock or inflammation fo the heart with decreased heart function, according to Dr. Rajapakse.

The Mayo Clinic hasn't had any cases and didn't find any evidence of the syndrome in children treated going all the way back through January. 

"This is very serious but it does seem to be very rare," said Rajapakse, who noted that the syndrome has been found in patients as young as a few months old but has appeared more commonly (still very rare) in school-aged children and teens. 

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Many of the syndrome's symptoms can appear in numerous other ailments, so if a parent is unsure about what their child is experiencing they are urged to contact their pediatrician and ask questions.

"If you have concerns about your child, definitely talk to your pediatrician," said Rajapakse. "It's very reasonable to pick up the phone and call your pediatrician if you're very worried. If your child is very ill, obviously take them into an emergency department so they can be assessed right away."

Minnesota State Epidemiologist Dr. Ruth Lynfield tells Bring Me The News that the state is working with the Centers for Disease Control and Prevention (CDC) to establish healthcare protocol for identifying possible cases. 

The Royal College of Paediatrics and Child Health has recommended case definition for clinicians to use when identifying the inflammatory syndrome. 

1. A child presenting with persistent fever, inflammation (defined as neutrophilia, elevated CRP and lymphopaenia) and evidence of single or multi-organ dysfunction (shock, cardiac, respiratory, renal, gastrointestinal or neurological disorder). This may include children fulfilling full or partial criteria for Kawasaki disease. 

2. Exclusion of any other microbial cause, including bacterial sepsis, staphylococcal or streptococcal shock syndromes, infections associated with myocarditis such as enterovirus (waiting for results of these investigations should not delay seeking expert advice). 

3. SARS-CoV-2 PCR testing may be positive or negative. 

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