Feb 24, 2021 - Health

For children, the COVID surge isn't over

Children's hospitals across the country say they're still seeing a surge of kids suffering from a serious illness that typically follows coronavirus infections.

The big picture: Severe coronavirus infections in children remain extremely rare, compared to the risk to adults. But persistent side effects from those infections mean that kids' hospitalization rates don't exactly mirror adults'.

Even as coronavirus hospitalizations decline overall, children's hospitals say they're still seeing large numbers of kids suffering from multisystem inflammatory syndrome, commonly known MIS-C, — a serious illness that generally occurs several weeks after a child is infected with the coronavirus.

  • MIS-C can cause inflammation in various body parts, and symptoms include fever, abdominal pain, vomiting and diarrhea. Most cases occur in children between 1 and 14 years old, and the condition disproportionately effects children of color, per the CDC.
  • "As the population in general seems to have fewer active cases, we are seeing more children being admitted with COVID-related problems, but most of those — I'd say more than half over the last five weeks — are children who have MIS-C," said Rob McGregor, chief medical officer at Akron Children’s Hospital.

What they're saying: Hospitals say the disease seems to be more common now than it was earlier in the pandemic, and children are sicker now than they were in earlier surges.

  • "The MIS-C has really hit us this time, and the last month has been way higher numbers and higher acuity than we [had] before with MIS-C — and that's hard to explain," said Lara Shekerdemian, chief of critical care at Texas Children's Hospital.
  • Unlike other children's hospitals interviewed by Axios, Texas Children's has also seen more severe cases of acute COVID too. "It feels like ... we have seen in the last two three months patients who are sicker when they present with COVID than we did in the early experience," Shekerdemian added.

By the numbers: Pediatric COVID-related hospitalizations increased by 50% between Oct. 1 and Jan. 7, according to an analysis of Health and Human Services data by the University of Minnesota COVID-19 Hospitalization Tracking Project.

  • Adult hospitalizations rose by almost 300% over the same period.
  • Adult hospitalizations have since fallen by 54%, while children's hospitalizations are down by 25%.
  • As cases began to rise in late November and December, "based on our experience, we said OK, MIS-C task force, mark your calendars," said Roberta DeBiasi, chief of the Division of Pediatric Diseases at Children's National Hospital in Washington, D.C. That surge began in January, and continues today.
  • The CDC only has complete information on the number of MIS-C cases specifically through mid-December, when they were on the rise.

What we're watching: The children's hospitals said that, based on previous trends, they expect the number of hospitalizations to fall in the coming weeks, a delayed result of the coronavirus's lower community prevalence.

  • "It seems like the peaks we had in the children's hospital lagged a little behind those we were seeing in the adult systems," said Ronald Ford, chief medical officer at Joe DiMaggio Children’s Hospital. "I would expect peds admissions to start to fall. Now, the big unknown here for everyone is how these new variants are going to affect things."
  • He said it's still unclear how the new virus variants impact children, and that it's a "distinct possibility" that they could be related to more severe cases of MIS-C.
  • "We don't know, but that’s one of those things that will have to be studied and looked into, if different variants have a different rate of severity of MIS-C in children," he added.
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