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COVID-19 in Maryland Health Care

Md. Seeing Increase in Post-Virus Illness That Hits Only Children

Doctor taking a swab sample. Stock photo by Mladen Sladojevic/Getty Images

Maryland is starting to see a gradual but steady increase in a mysterious post-coronavirus illness that appears only to affect children.

Multi-system Inflammatory Syndrome in Children, or MIS-C, strikes children three to four weeks after a COVID-19 exposure or infection, doctors say. The syndrome typically brings a range of symptoms and a considerable amount of discomfort, though almost all patients recover.

The longterm effects are unknown.

After hitting Europe and in the New York City area, cases have been popping up elsewhere in the last couple weeks.

A spokesman for the Maryland Department of Health said there have been 17 known cases of MIS-C in the state, with one death.

“Every day we get emails or phone calls,” said Dr. Charles Berul, the head of cardiology at Children’s National in Washington, D.C., in a recent interview. “It’s not even noon and I’ve had three today.”

Berul describes MIS-C as a “constellation” of symptoms that includes fever, a rash, conjunctivitis, swollen lymph nodes under the neck, cracked lips with a strawberry appearing tongue, swollen hands and feet, and peeling of the finger tips.

According to the Centers for Disease Control and Prevention, patients also frequently experience abdominal pain, vomiting, diarrhea, bloodshot eyes and fatigue.

Berul said MIS-C is similar to Kawasaki Disease, a rare condition that was first identified about 60 years ago.

In many cases children who have it don’t even know they were exposed to COVID-19 because their immune system fought it off without getting any symptoms.

“They get an immune reaction to the virus,” Berul said. “So it’s a post-infection reaction. … The immune response to the infection is almost an overreaction and it causes things to inflame.”

While some hospitals are using steroids, Children’s has had success with high-dose aspirin, gamma globulin and other medications to decrease inflammation. The hospital, which draws heavily from the Maryland suburbs, has had 30 cases. All have recovered.

The unknown, the doctor said, is what impact the inflammation will have on a child’s development. “It’s too early to know what the long-term effects are going to be.”

“We’re optimistic that the coronary arteries are responding to the treatment and that children are getting better,” he said. “But we need to monitor the coronary arteries for a longer period of time. Maybe up to a year.”

The child who died in Maryland was a 15-year-old Baltimore County resident who passed away on May 19. The child was the first pediatric death in the county.

Berul advised parents to have “a high degree of suspicion” if their kids have more than one of the symptoms associated with MIS-C, and to contact their pediatrician.

“We believe that the early treatment is what’s going to prevent the permanent damage to the coronary arteries.”

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