Romano Law Nurse Corner #10
CHILDREN AND COVID-19
Pediatric Multi-System Inflammatory Syndrome = PMIS
The rapidly evolving COVID-19 pandemic continues to change our lives in many ways. It can be overwhelming to keep up with the latest news. We all miss our favorite spots, social interactions and things that are “normal”. No matter what, we all need to stay diligent with our safety measures. We will all work toward our new “normal”.
Children have been showing up at hospitals all over the world with an unusual grouping of symptoms for which they are testing positive for the COVID 19 virus. These symptoms can include inflammation in the skin, eyes, blood vessels and heart, irritability, sluggishness, along with fever, rash, swollen lymph nodes and abdominal pain. Other symptoms to be aware of are swelling and redness in the hands and feet, redness or cracking in the lips or tongue and swollen lymph nodes in the neck. Organ failure and death can result. This newly identified illness has been named pediatric multi-system inflammatory syndrome or PMIS.
While there have not been a large number of publicized cases of children affected with this virus, the numbers of cases are rising. Many people incorrectly believe that children are safe or have some sort of immunity from COVID-19. Sadly, this is not what physicians and scientists are seeing first hand. Parents are well-advised to stay thorough in assessing their children during this pandemic, even if no known exposure has occurred.
It appears that PMIS is similar to Kawasaki’s disease, a rare but serious childhood illness whose cause is unknown, however believed to be an immune system response to infection. While the symptoms of PMIS are not the same as Kawasaki’s disease, they are very similar and overlap in many areas. Aneurysm and damage to the heart, which show up later in the progression of the disease, are the most serious effects of Kawasaki’s disease and children are aggressively treated and monitored for these side effects. Similarly, children with PMIS need continued monitoring for these possible effects.
The first real data regarding PMIS was reported last week from an Italian retrospective study documenting the strong link between COVID-19 and PMIS. This study looked at the records of children admitted to the pediatric unit from January 1, 2015 to April 20, 2020. They compared symptoms and characteristics of that group to the children admitted to the hospital after the pandemic began. Most patients diagnosed with PMIS tested positive for Covid-19 or the antibodies (indicating exposure) yet did not have the classic symptoms we are used to seeing. Further, since the symptoms can show up after the infection has resolved, the child may never have shown typical signs of COVID-19 and only shown signs of PMIS. These findings show the connection, however further research is necessary.
The first reported cases of PMIS in the United States occurred in NY in early May about a month after the surge of infections was at its peak. Physicians and scientists have already detected slightly over 100 cases with three deaths from the disease. Last week, Connecticut started seeing children with suspected PMIS at Yale New Haven Children’s Hospital. Many experts believe this trend will continue with more children presenting with PMIS.
According to Dr. Marietta Vazquez, a Yale Medicine pediatric infectious disease specialist and Dr. Clifford Bogue, chair of Yale Medicine Pediatrics and chief medical officer of Yale Newhaven Children’s Hospital, the current treatment for PMIS is modeled after the treatment for Kawasaki’s syndrome. This treatment decreases the body’s immune response, which is vital to reduce the risk of cardiac complications. Specifically, these treatments can include antibiotics, high-dose steroids, intravenous immunoglobulin (blood plasma that contains antibodies), and a biologic medication commonly used for rheumatoid arthritis and other inflammatory diseases. Doctors say the treatments have been working well and parents should not be afraid to bring their child to the doctor or emergency room.
While some experts have said that the level of inflammation in the heart tends to be higher with PMIS and the syndrome more severe compared to Kawasaki’s disease, Dr. Vazquez stresses that “overall, our patients are doing well, and this is not a cause for a panic…it is a message to be vigilant”.
If you have any concerns regarding your child’s health reach out to their health care provider.
Let’s all remain vigilant and stay safe.
https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-pmis.pdf [NYS PMIS Fact Sheet]
We are Susan Ramsey and Amie Goldberg, both practicing attorneys and nurses here at the Romano Law Group. Here is a little more about each of us:
Susan Ramsey is both an attorney and an RN. Ms. Ramsey’s professional experience began as a Registered Nurse in the Intensive Care Unit at Yale New Haven Hospital. While pursuing her Bachelor’s Degree, she was a counselor with the New Haven Rape Crisis Program. During her time with the Program, Ms. Ramsey counseled sexual assault survivors and performed seminars for local police departments, universities, and high schools. During her time working as a registered nurse, Ms. Ramsey decided to attend law school. Ms. Ramsey graduated from CUNY Law School, and has practiced law in several different State and Federal Courts. She is a Florida Heath Care Risk Manager and a member of the Palm Beach County Sober Home Task Force. Ms. Ramsey actively litigates cases involving catastrophic injuries and wrongful death on behalf of survivors, cases include injuries suffered by victims of professional negligence, product liability and medical negligence.
Amie Goldberg is both an attorney and a certified APRN. After completing a Bachelor of Arts Degree at Whittier College, Ms. Goldberg attended nursing school at Emory University. Ms. Goldberg’s professional experience started as a Registered Nurse at Egleston Children’s Hospital taking care of children with congenital heart disease. After a few years, she continued working in all areas of the hospital while attending Kennesaw State University on weekends in order to get her Master’s Degree in Nursing with a specialty of Primary Care Nurse Practitioner/Family Nurse Practitioner. During her time as an APRN, Ms. Goldberg decided to attend law school at St. Thomas University in Miami, Florida. Since graduating, she has mainly practiced in the areas of personal injury and worker’s compensation, fighting for the rights of injured people. Since joining the Romano Law Group, Ms. Goldberg has been the Director of the Opioid Litigation Project. Ms. Goldberg also practices in the area of
medical malpractice and nursing home negligence, bringing an inside perspective and knowledge to help get justice for our clients.