When the COVID-19 pandemic began in earnest in the United States, one piece of information parents held tight was that kids didn’t seem to be as susceptible to the novel coronavirus or have as severe or long-lasting symptoms compared to adults. But now with reports out of at least 14 states suggesting children are developing Pediatric Multi-System Inflammatory Syndrome after contracting or being exposed to the coronavirus, parents’ initial perceptions have been turned on their head.

Pediatric Multi-System Inflammatory Syndrome (PMSI) affects blood vessels and organs with symptoms similar to Kawasaki Syndrome and toxic shock. Unlike Kawasaki Syndrome, which tends to affect children age 5 and younger, the cases of PMSI with a potential correlation to COVID-19 have affected infants through teens. Local pediatrician Dr. Erica Faulconer with Northwest Pediatrics in Oklahoma City says the ages of 5 to 14 have seen the highest instance of this syndrome connected to COVID-19.

The state of New York is investigating more than 100 children with Pediatric Multi-System Inflammatory Syndrome, of whom one in four has been sick enough to require hospitalization. Three children have died. The Today Show reported that 40 percent of children with this secondary infection did not have an underlying medical condition.

Also of concern is that the development of PMSI related to COVID-19 in kids results in drastically different coronavirus symptoms than what adults typically experience. In addition, some of the children who’ve developed the secondary syndrome were asymptomatic or didn’t even realize they’d had or were exposed to COVID-19, and on average, PMSI symptoms haven’t occurred until four to six weeks after a child’s exposure.

The syndrome is not currently being reported in Oklahoma, and Faulconer asserts that because our state has not seen COVID-19 infection percentages rise as high as other states like New York, it’s unlikely Oklahoma will see this syndrome occurring as frequently in our children. Faulconer also reassures that post-viral inflammatory illnesses are not new and that she and other physicians around the state are trained and experienced in both diagnosing and treating them.

It is critical for Oklahoma parents to be aware of this developing situation and understand the symptoms to watch for, even if they don’t believe their child has had COVID-19 or been exposed to the coronavirus. In combinations, rash, high fever for more than five days, a “strawberry tongue” (enlarged and pink tongue), conjunctivitis and low blood pressure are key indicators of PMSI. Faulconer says the biggest concern with PMSI, like Kawasaki Syndrome, is the subsequent inflammation of the vessels and organs, specifically the heart, kidneys and liver.

“Kids with fever for more than five days need to be seen by their doctor, 100 percent of the time,” advises Faulconer. “You have the best knowledge of your child. If you see something out of the ordinary, like rash, persistent fever, fatigue or they just don’t seem like themselves, your pediatrician is your best resource.”

When caught early, PMSI is highly treatable, and Faulconer assures that physicians can quickly put measures in place to deal with even the most serious of symptoms from PMSI related to COVID-19 in children. Many of the children around the country who’ve had to be hospitalized with dangerous symptoms have recovered enough to return home within several days to a week.

According to Scott Gottlieb, MD, former FDA commissioner, Science Magazine reports that kids are about one-third as susceptible to COVID-19 as adults, with data for the study coming out of China. He says this suggests kids are contracting the virus at a lower rate than adults and/or that they are asymptomatic or not detecting they have the virus.

Faulconer cautions that antibody and even COVID-19 tests are not 100 percent accurate, or the best predictor. Some of the kids around the country who’ve developed PMSI have tested negative for COVID-19 and/or antibodies, but that doesn’t necessarily mean they haven’t had it or weren’t exposed.

“Most of the time when we’re testing for other things we have so much experience that the tests are really accurate,” said Faulconer. “But we’re not at that place yet [with COVID-19].”

Faulconer is hopeful Oklahoma has reached a plateau but says it’s imperative for families not to become cavalier in preventative measures like frequent hand washing, wearing face masks, maintaining social distancing protocols and avoiding indoor crowds especially as additional spikes or resurgences may be an issue.

As the state of Oklahoma moves through reopening phases over the next several weeks, find more of Faulconer’s recommendations for parents for keeping kids safe and enjoying family fun while also respecting our new normal this summer.

This article was published May 15, 2020. This is a developing situation. For the most up-to-date information, visit the CDC or your county or state health departments’ websites.