New discoveries on two ways children can get seriously ill from coronavirus

A Large-scale national survey Found that there are important differences between the two main ways children are seriously ill with the coronavirus. This can help doctors and parents better recognize their condition and gain a deeper understanding of their children at risk.

Published in the journal JAMA on Wednesday, the study analyzed 1,116 adolescents treated in 66 hospitals in 31 states. More than half of the patients had acute Covid-19. It is a disease primarily related to the lungs and afflicts most adults infected with the virus.On the other hand, 539 patients Inflammatory syndrome It erupted weeks after they typically had a mild initial infection.

Researchers found some similarities, but there were also significant differences in symptoms and characteristics of patients hospitalized from March 15 to October 31, last year, ranging from infants to 20 years of age. ..

A young man with a syndrome called Pediatric multisystem inflammatory syndrome or MIS-CIs likely to be between the ages of 6 and 12, with more than 80% of patients with acute Covid-19 under the age of 6 or over the age of 12.

More than two-thirds of patients with either condition are black or Hispanic, and experts may reflect socio-economic and other factors that have exposed some communities to the virus disproportionately. It says it is expensive.

“It’s still shocking that the overwhelming majority of patients are non-white and that applies to MIS-C and acute Covid,” said Jean, medical director of pediatric heart transplantation and advanced heart failure in children’s hospitals and healthcare. A. Dr. Ballweg said. The Omaha center that was not involved in the research. “There is a clear racial disparity there.”

For unknown reasons, young Hispanics appeared to have an equal risk of both conditions, but black children seemed to be at higher risk of developing inflammatory syndrome than acute illness, Adrian said. Dr. Randolph said. Research and Pediatric Emergency and Critical Care Specialist at Boston Children’s Hospital.

One of the potential clues mentioned by the author is that Kawasaki disease is a rare childhood inflammatory syndrome. There are similarities with some aspects of MIS-CBlack children have a high frequency of heart abnormalities and appear to be less responsive to intravenous immunoglobulin, one of the standard treatments.

Researchers have found that adolescents with inflammatory syndrome are much more likely to have no underlying condition than adolescents with acute covid. Still, more than one-third of patients with acute covid were previously ill. “Previously healthy children are not completely free from Scottish people here,” said Dr. Randolph.

The study evaluated obesity separately from other underlying health conditions and found that a slightly higher proportion of adolescents with acute covids were obese only in patients aged 2 years and older.

Dr. Srinivas Murthy, an associate professor of pediatrics at the University of British Columbia who was not involved in the study, said he was not convinced that the findings proved that healthy children were at increased risk of MIS-C. It could be a game of numbers, mostly with a proportion of infected children and a proportion of healthy children, rather than saying that “healthy children have immunity that poses a disproportionately high risk.” There is, “he said.

Overall, he said the documentation of the study on the differences between the two conditions was useful, especially because it reflected “a reasonably representative set of hospitals throughout the United States.”

Young people with inflammatory syndrome were more likely to need treatment in the intensive care unit. These symptoms included gastrointestinal problems, inflammation and were much more likely to be related to the skin and mucous membranes. Many patients with acute covid had not undergone a detailed heart assessment, but they were also much more likely to have heart-related problems, the study said.

Almost the same majority (more than half) of patients in each condition required respiratory assistance, just under one-third of those who required mechanical ventilation. Almost the same small number of patients died in each group: 10 for MIS-C and 8 for acute Covid-19.

Data is not reflected Recent surge in the case of inflammatory syndrome This was after a general increase in Covid-19 infections across the country during the winter holiday season. Some hospitals report a higher number of seriously ill MIS-C patients in the current wave compared to the previous wave.

“Recently, I’ve felt that MIS-C children are getting more sick, so I’ll be fascinated by the comparison between this group after November 1st,” said Dr. Ballweg.

The optimistic sign from this study was that most of the serious heart problems in adolescents with inflammatory syndrome improved to normal within 30 days. Still, Dr. Randolph said the residual effect is still unknown.That’s why one of her co-authors, Dr. Jane Newberger, Deputy Chief of Cardiology at Boston Children’s Hospital National survey Follow children with inflammatory syndrome for up to 5 years.

“We can’t say 100% certainty that everything will be normal in the long run,” said Dr. Randolph.