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Sunday, April 11, 2021

Dangerous COVID-related condition hitting Black children

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At Riley Children’s Hospital in Indianapolis, Dr. Samina Bhumbra has been receiving calls for help from health centers across the state. Callers describe children with symptoms such as high fever, red eyes, swollen lips and abdominal pain.

To Bhumbra, an assistant professor of clinical pediatrics, that can point to a potentially fatal condition known as MIS-C. It’s rare but appears to be increasing with every COVID surge.

Multisystem Inflammatory Syndrome in Children has become all too familiar to Riley’s specialists. They’ve seen dozens of cases.

“It’s still a very rare phenomenon today,” Bhumbra said. “There have been about three million COVID cases in children since the beginning of the pandemic. But really, about 2,000 children have been diagnosed with MIS-C.”

The condition is characterized by severe inflammation that affects organs such as the heart and lungs. MIS-C can happen during a COVID infection or weeks later — even when a child hasn’t shown symptoms of the virus. 

There are 33 reported deaths nationwide. 

MIS-C affects every child differently, and doctors are unsure why some develop it and others don’t. But they say it’s hitting Black and Latinx children especially hard. 

“Just like with COVID-19 impacting minority populations, we have seen that pattern with MIS-C as well,” Bhumbra said.

According to the CDC, 2,617 children got MIS-C nationwide. Nearly 70% are Black or Latinx. 

Kendrick Moore, a 9-year-old who lives north of Chicago, got MIS-C last March — one of the nation’s first cases.

“Since then, I’ve been pretty famous,” he said.

Kendrick paid a big price for that fame. When he developed MIS-C, his heart was failing, and so were his kidney, liver and pancreas. He spent 12 days in an intensive care unit at Lutheran General Hospital in Illinois. 

Almost a year has passed since he got home. But Samantha Geer, his mom, said he’s still battling some lingering effects.

“We first noticed the brain fog. … He doesn’t complete a full task,” she said. “Almost all of his hair fell out. It was coming out in clumps. And then the headaches started. And then there’ll be a random stomach ache here or there.”

MIS-C’s long-term effects are still unknown, and doctors are especially worried about the impact on the heart. They recommend that patients follow up with various specialists for up to a year or more. 

Kendrick sees a cardiologist, infectious disease specialist and a neurologist. Doctors also say he needs to see a neuropsychologist to help with the trauma; part of it comes from being poked and stuck over and over.

His mom says going to the doctor’s office is a trigger for him now.

“At any doctor’s appointment his first question is, do I need a blood test,” Geer said. “He had a central line through his groin. He had an arterial line, and he had all the IVs from that first day that got the veins so sore and blown.”

But being on a Medicaid plan meant that none of the neuropsychologists within 75 miles would accept Kendrick’s insurance. And the only doctor she found has more than a year’s wait for an appointment. It’s yet another disparity that puts many low-income Black and Latinx children at a disadvantage. 

“It’s so beyond frustrating and then again, they’re the kids who are not going to be able to get the follow up care because of the neighborhoods they’re living in,” Geer said. “It’s not fair. He didn’t choose this.”

And it’s not just the post-COVID inflammation that Black and Latinx children struggle with. A nationwide study published in JAMA suggests that if they contract the virus, they are also more likely to suffer from severe COVID symptoms. 

Doctors and researchers are trying to figure out why children react differently to COVID.

Dr. Courtney Rowan, an associate professor who works in Riley’s pediatric ICU, participated in the nationwide study. She and other doctors are trying to understand this disparity by looking at a multitude of factors.

“Is there something in your genetic profile that makes you more predisposed to have bigger inflammatory reactions or to get sick or when you’re exposed to this particular virus?” Rowan says. Or it could be tied to social and economic factors.

Even before the pandemic began, Black children suffered from many health disparities. For example, they are nearly twice as likely to have asthma, even when adjusting for income and family characteristics. 

Rowan said getting vaccinated is the only way families can protect their children — especially those in vulnerable populations.

“Our children are not able to be vaccinated right now, there’s not a vaccine that exists …” she said. “And I think that these racial disparities that we’re seeing within COVID and COVID-related illnesses really hammer home the need to make sure that we’re providing access to the vaccine across all social and racial populations within the state.”

As doctors search for ways to address these disparities, Kendrick misses some of the normal joys of childhood — such as sledding with friends at the beginning of the year. 

“I haven’t gone sledding any time before that. Because of my asthma,” he said. “It was really fun. And I wish I could do it again. All of the snow is melted.”

This story was reported as part of a partnership between WFYI, Side Effects Public Media and the Indianapolis Recorder. Contact Farah Yousry at fyousry@wfyi.org or 857-285-0449. Follow her on Twitter @Farah_Yoursrym.

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