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New COVID-19 Complications: Are Children at Higher Risk?

Recently, a possible link has been reported between COVID-19 and a serious inflammatory response that affects multiple organs, including the heart. Children with this potentially dangerous complication have been reported in multiple states, including Louisiana. While new information is still being discovered, here is what Ochsner Hospital for Children knows about this newly identified syndrome.

How does COVID-19 affect children?

Children are less likely to contract the novel coronavirus than adults. Of the children who are infected with COVID-19, most have very mild symptoms, including cold-like symptoms, fever, headache, sore throat and cough. Some children have abdominal pain, vomiting or diarrhea.

What is pediatric inflammatory COVID-related syndrome?

This syndrome has features that overlap with Kawasaki disease and toxic shock syndrome. Kawasaki disease is caused by inflammation or irritation of blood vessels and tends to affect the coronary arteries, which supply blood to the heart. Toxic shock syndrome is a rare but life-threatening complication of an infection and causes fever, rash and low blood pressure, and can result in damage to multiple organs.

Patients with pediatric inflammatory COVID-related syndrome have fever, abdominal pain, trouble breathing, chest pain, evidence of inflammation on laboratory testing, and dysfunction of at least one organ system (kidney, heart, brain or gastrointestinal tract). This syndrome has been reported in patients who test both positive and negative for COVID-19 by nasal swab as well as both positive and negative for the antibodies to COVID-19 by blood tests. The syndrome has been reported weeks after possible COVID-19 infection.

What are the more common symptoms?

  • Fever
  • Severe abdominal pain, vomiting, diarrhea
  • Sore throat
  • Trouble breathing
  • Chest pain
  • Conjunctivitis (pink eye)
  • Rash
  • Swollen or peeling hands or feet
  • Swollen, red or chapped lips
  • Swollen lymph nodes

How is the syndrome diagnosed?

Children with suspected inflammatory response should be evaluated promptly. In addition to a history and physical examination, patients are likely to need X-rays, blood tests and a nasal swab to test for COVID-19. Some children will need cardiac evaluation with an electrocardiogram and/or echocardiogram.

What is the treatment?

Children may require close monitoring in the pediatric intensive care unit. The primary means of treatment is supportive care, including IV fluids, oxygen or respiratory support, and medications that support blood pressure. In addition, several medications that are commonly used to treat Kawasaki disease and toxic shock syndrome are being used to treat this inflammatory syndrome, including intravenous immunoglobulin, steroids and medications that alter the immune response.

The team at Ochsner Hospital for Children have become national leaders in treating this condition. For up-to-date information and resources on COVID-19, visit www.ochsner.org/coronavirus.

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About Ochsner Health

Ochsner Health is a system that delivers health to the people of Louisiana, Mississippi and the Gulf South with a mission to Serve, Heal, Lead, Educate and Innovate. Ochsner Health is a not-for-profit committed to giving back to the communities it serves through preventative screenings, health and wellness resources and partnerships with innovative organizations that share our vision. Ochsner Health healed more than 876,000 people from across the globe in 2019, providing the latest medical breakthroughs and therapies, including digital medicine for chronic conditions and telehealth specialty services. Ochsner Health is a national leader, named the top hospital in Louisiana and a top children’s hospital by U.S. News & World Report. As Louisiana’s leading healthcare educator, Ochsner Health and its partners educate thousands of healthcare professionals annually. Ochsner Health is innovating healthcare by investing in new technologies and research to make world-class care more accessible, affordable, convenient and effective. Ochsner's team of more than 26,000 employees and 4,500 providers are working to reinvent the future of health and wellness in the region. To learn more about Ochsner Health, please visit www.ochsner.org. To transform your health, please visit www.ochsner.org/healthyyou.