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MDH issues advisory on potential COVID-linked syndrome in children

Some children are getting "very severely ill" with MIS-C, the state epidemiologist said Friday.

The Minnesota Department of Health (MDH) has issued an advisory asking providers and parents to keep an eye out for a syndrome in children that may be related to COVID-19, called MIS-C (multisystem inflammatory syndrome in children).

Dr. Ruth Lynfield, the state epidemiologist, said that globally, children from a young age through adolescence have presented with fever, signs of inflammation, and many of them have had abdominal pain, diarrhea or vomiting. A rash, swollen hands or feet, and red or pink eye can also be symptoms.

"We are just trying to figure out what is going on here now that people are observing this," Lynfield said Friday on the daily MDH briefing call.

The syndrome has been reported in the United Kingdom, France and Italy, and Lynfield said it has been identified in over 100 children in New York, with three deaths in that state.

Some children are getting "very severely ill" with MIS-C, Lynfield said, with more than two organs impacted. Many of them have had heart involvement, but also kidney, lungs, gastrointestinal, and neurological manifestations. Most of the children, however, have gotten better, according to Lynfield.

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Some of these children have tested positive for COVID-19, Lynfield said. Some did not test positive, but blood tests showed antibodies consistent with exposure to the virus. Some children also had family members who had been ill, and symptoms presented a number of weeks later.

"We are learning more about some of the complications that may be occurring," she said. "We need to look into this more but certainly in some children there has been this connection."

Some of these children have presented as having Kawasaki disease, Lynfield said, but are older than the specific age range for that illness. Some have also presented with something like toxic shock syndrome. 

Kawasaki disease, which typically occurs in children under the age of 5, is associated with fever and red eyes, inflamed and cracking lips, a strawberry-colored, inflamed tongue, swollen hands and feet, and enlarged lymph nodes.

Health officials do not know for certain whether MIS-C is connected with COVID-19 but "we think it probably is," Lynfield said.

Dr. Lynfield said parents should continue to follow social distancing and recommended hygiene guidelines for their children.

MDH does not yet have data on MIS-C cases in Minnesota, but Infectious Disease Director Kris Ehresmann said they have seen 176 cases of COVID-19 in children from birth to 5 years old, and 763 cases in children ages 6 to 19. Of all those cases, 27 have been hospitalized and no one has died.

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The state of Minnesota has set up a hotline for general questions about coronavirus at 651-201-3920 or 1-800-657-3903, available 7 a.m. to 7 p.m. There is also a data portal online at mn.gov/covid19.