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Doctors Continue Research Into Rare Inflammatory Syndrome In Children With COVID-19

DAVID GREENE, HOST:

So doctors have been learning more about a rare inflammatory syndrome in some children who've been exposed to the coronavirus. Only a few hundred cases of this have been confirmed so far in the U.S., but some of these children have needed intensive care, and a handful have died. The good news is that most recover fully. Fred Mogul of member station WNYC in New York met with one family in the Bronx that has been impacted.

(SOUNDBITE OF BEEPING)

UNIDENTIFIED PERSON: I'm going to clean your legs so the stickers will stick, OK?

FRED MOGUL, BYLINE: Five-year-old Israel Shippy is getting an EKG to measure the electric signals sent out by his heart. Fifteen wires are attached to stickers on his arms and legs and across his chest. It doesn't take very long.

ISRAEL SHIPPY: I am done?

UNIDENTIFIED PERSON: You're done. You did a wonderful job.

MOGUL: As his mom helps the nurse remove the stickers, Israel tells me about his favorite cartoons and about the ideas that pop into his head all the time because when he grows up, he's going to be an inventor.

ISRAEL: I got an idea that I need something that can light up, attach it on something with glue, so if you don't have a flashlight, you can just use it.

MOGUL: Israel contracted the coronavirus in late April, but he didn't have the typical COVID-19 symptoms. He had a persistent fever but no problems breathing. But day by day, things started getting worse.

JANELLE MOHOLLAND: He was not eating. He was not using the bathroom. He had abdominal pains.

MOGUL: Janelle Moholland is Israel's mother.

MOHOLLAND: His eyes were not the normal color. They were starting to get red.

MOGUL: They went to the emergency room a couple times, but the doctor sent them home without a coronavirus test. With Israel refusing to eat and barely drinking anything, she felt powerless.

MOHOLLAND: There was nothing that I could do but make him comfortable.

MOGUL: As Israel grew sicker, Moholland grew frustrated. She knows COVID-19 has hit the African American community hardest, and she feels like a victim of that disparity.

MOHOLLAND: You know, it affects me personally because, of course, I am African American. But you just never know. It's hard. We're living in uncertain times, very uncertain times.

MOGUL: After seven long days, Israel was finally admitted to the Children's Hospital at Montefiore in the Bronx. Testing confirmed he had the virus, so they gave Israel fluids and a substance called immunoglobulin to prevent his immune system from attacking his arteries. After that, he got better pretty quickly.

MOHOLLAND: He started trying to walk around. That was a little hard for him because he was weak. He started watching TV. He asked for something to eat.

MOGUL: Doctors diagnosed Israel with multisystem inflammatory syndrome in children, or MIS-C. It's relatively rare and seems to respond well to treatment, but MIS-C is new enough and mysterious enough that doctors at Montefiore want to make sure that children don't experience health problems down the road. So they've set up an extensive follow-up program.

NADINE CHOUEITER: We've seen these kids get really sick and get better and recover and go home.

MOGUL: Dr. Nadine Choueiter is a pediatric cardiologist.

CHOUEITER: Yet we don't know what the long-term outcomes are. And that's why we will be seeing them.

MOGUL: Choueiter says MIS-C seems to be caused by an overreaction to the coronavirus.

CHOUEITER: The immune system of certain children starts attacking the body itself, including the arteries of the heart.

MOGUL: There don't appear to be any risk factors for MIS-C, such as childhood diabetes or asthma, but boys do appear a little more likely to get it than girls.

CHOUEITER: We think there are some children who are predisposed, but we haven't identified a gene that's responsible. And we don't know why it happens in one child and not in their siblings.

MOGUL: Janelle Moholland worries about long-term effects in her son. Before Israel's follow-up appointment, she wrote down a bunch of questions.

MOHOLLAND: Does it really affect his heart? Does it affect the function of his organs? Will the swelling, like, come back? Just like - 'cause he had swelling internally, so that was scary.

MOGUL: Montefiore is tracking 39 kids, and Dr. Choueiter says so far they appear to have no lingering problems.

CHOUEITER: We have not seen any decrease in heart function. When we check their blood, their inflammatory markers are back to normal.

MOGUL: The team wants families to come back for periodic checkups for at least a year. Moholland is glad the hospital is being vigilant.

MOHOLLAND: The uncertainty of not knowing, it's a little, you know, unsettling, but I am hopeful.

MOGUL: She's not alone in hoping that MIS-C will turn out to be benign in the long run and that for these children it will just become a distant memory of a brief illness they had back in the turbulent year that was 2020. For NPR News, I'm Fred Mogul in New York.

(SOUNDBITE OF YONDERLING'S "WEST WINDOW")

GREENE: That story comes from NPR's reporting partnership with WNYC and Kaiser Health News. Transcript provided by NPR, Copyright NPR.

Fred Mogul