Up to 5 NY children dead, 93 sickened by rare COVID-related Illness

New York may have as many as 93 cases of children presenting with a new pediatric multi-system inflammatory syndrome likely linked to COVID-19. At least three children have died, and two more deaths are under investigation, Gov. Andrew Cuomo announced.

Cuomo previously confirmed the deaths of two boys in New York City and Westchester County, as well as a teenager in Suffolk County. Details on the two most recent fatalities weren't immediately available.

A complication of the coronavirus the state had not even acknowledged a week ago, this new condition is now being seen across the country and is striking newborns and teenagers alike.

"As it turns out, these children happened to have the COVID antibodies, or be positive for COVID, but those were not the symptoms they showed when they came into the hospital system," Gov. Cuomo said Saturday.
The New York State Dept. of Health is working in partnership with the CDC to develop national criteria for the health departments and hospital systems in the 49 other states to help them identify, track and respond to help children exhibiting symptoms, Gov. Cuomo said. Doctors in the state say children are not presenting with symptoms until 4 to 6 weeks after exposure to the virus.

"This is every parent's nightmare, right?" Cuomo said, adding that the state is investigating additional child deaths and will conduct further studies to better understand the illness.

New Jersey was said to be investigating eight possible cases of the illness in the state, though they were not yet confirmed. Connecticut Gov. Ned Lamont said Monday there were three cases at Yale New Haven Hospital.

While Lamont said the issue didn't wasn't addressed during a governor's call with the White House, President Trump fielded questions regarding the pediatric syndrome during his afternoon press conference, saying "it's been on the radar for weeks" and that officials were looking into it.

"We're studying that very closely ... we've seen this for quite a while. It's been very rare, but we're looking at it very closely," Trump said.

At Westchester Medical Center, where one of the children with the illness died, more than a dozen other children have been treated, not including the multiple cases since Monday afternoon. Dr. Michael Gewitz, the hospital's director of pediatrics, said there have been more cases as more parents are coming in to the ER since local officials put out the warning.

"We've seen a bump in both the number coming to the emergency room, a small bump, but more in terms of the number who call, and that's good," Gewitz said.

A 5-year-old boy died in New York City Thursday, the first child identified by the state to die from inflammatory syndrome brought on by COVID-19 complications.

New York City confirmed the syndrome's presence in at least 38 children over the weekend. On Monday, Dept. of Health Commissioner Dr. Oxiris Barbot said an additional 12 cases were under investigation and would be reportable in the coming days.

"If [your child has] a fever, their energy level is off, their appetite is off, they're developing a rash, their lips look extra red, their tongue is looking extra red, those I think are the early signs that we want parents not to discount them and say 'oh they'll be better tomorrow' but to reach out to your pediatrician, have that conversation and then do the testing if your pediatrician thinks its indicated," Dr. Barbot advised.
How to Identify the Symptoms Early
So what are the symptoms of pediatric multi-system inflammatory syndrome? The NYC Health Department said that children had a fever, and more than half reported having rashes, abdominal pain, vomiting or diarrhea. While it has been considered a direct symptom of COVID-19, less than half of the pediatric patients in the city displayed any shortness of breath.

"I want to keep reminding parents and family members to look out for these symptoms and act quickly," NYC Mayor BIll de Blasio said.

Any child that shows symptoms relating to Kawasaki disease or toxic shock syndrome should be seen by a doctor as soon as possible, as the health department said early recognition and a pediatrician's referral to a specialist are essential, including admission to critical care units if necessary. Beginning treatment quickly can help prevent end-organ damage and other long-term problems, Demetre Daskalakis, the Deputy Commissioner of Disease Control with the New York City Health Department, said in the city's medical alert.

Dr. Newburger suggests that any parent who finds their child to have a high fever and "seems unwell" should call their pediatrician and seek medical attention.

Mount Sinai Hospital previously confirmed reports by NBC New York that they are seeing the new and unusual COVID-19 related illness in several pediatric patients, up from just two on April 28. The hospital’s chief of pediatric critical care issued a warning to parents to be on the lookout for certain symptoms.

In a statement, Dr. George Ofori, Pediatric Critical Care Director at Mount Sinai Kravis Children’s Hospital said, "Some of the cases that we are currently treating entered our care presenting with symptoms such as abdominal pain, vomiting, diarrhea, and a low-grade fever. Others presented first with a rash, conjunctivitis, and/or cracked lips.”

Dr. Ofori said some patients have developed heart problems and low blood pressure that led to shock. He explained that some had been diagnosed with COVID-19 2-3 weeks before these symptoms developed.

"Whether the underlying condition is COVID-19 or the body’s response to COVID-19 is not known at this time. While it is too early to definitively say what is causing this we believe it is important to alert the public as to what we are seeing," he said.

A different source told NBC New York some of these children had no previous underlying health conditions.  
The Mount Sinai statement came two days after Dr. Ofori’s counterpart at Cohen Children’s Hospital on Long Island told the I-Team in an interview they’ve seen about a dozen critically ill pediatric patients in the past weeks with similar inflammatory symptoms. 

“We now have at least about 12 patients in our hospital that are presenting in a similar fashion, that we think have some relation to a [COVID-19] infection,” said Dr. James Schneider, Director of Pediatric Critical Care at Cohen Children’s Hospital in Nassau. “It’s something we’re starting to see around the country.” (nbcnewyork)