HJNO Jul/Aug 2020

62 JUL / AUG 2020  I  HEALTHCARE JOURNAL OF NEW ORLEANS Hospital Rounds Reactive results occur after a COVID-19 infec- tion and can be indicative of an acute or recent infection. At this time, it is not known how long these antibodies will persist or whether or not they infer immunity to COVID-19. Non-reactive tests do not preclude a current or previous COVID-19 infection. STHS diagnostic centers are the Cordes Pavil- ion, 16300 Hwy 1085 in Covington, open weekdays from 7 a.m.-6 p.m. and Saturdays from 7 a.m.-11 a.m., and the Mandeville Diagnostic Center, 201 St. Anne, Suite B, open weekdays from 7 a.m.- 4:30 p.m. Call (985) 871-5665 for more information. NewCOVID-19 Complications: Are Children at Higher Risk? Recently, a possible link was reported between COVID-19 and a serious inflamma- tory response that affects multiple organs, including the heart. Children with this potentially dangerous complication have been reported in multiple states, including Louisiana. While new information is still being discovered, here is what Ochsner Hospital for Children knows about this newly identified syndrome. How does COVID-19 affect children? Children are less likely to contract the novel coronavirus than adults. Of the chil- dren who are infected with COVID-19, most have very mild symptoms, including cold- like symptoms, fever, headache, sore throat, and cough. Some children have abdominal pain, vomiting, or diarrhea. What is pediatric inflammatory COVID- related syndrome? This syndrome has features that overlap with Kawasaki disease and toxic shock syndrome. Kawasaki disease is caused by inflammation or irritation of blood vessels, and tends to affect the coronary arteries, which supply blood to the heart. Toxic shock syndrome is a rare but life-threaten- ing complication of an infection and causes fever, rash, and low blood pressure; it can result in damage to multiple organs. Patients with pediatric inflamma- tory COVID-related syndrome have fever, abdominal pain, trouble breathing, chest pain, evidence of inflammation on labora- tory testing, and dysfunction of at least one organ system (kidney, heart, brain or gastrointestinal tract). This syndrome was reported in patients who test both positive and negative for COVID-19 by nasal swab as well as both positive and negative for the antibodies to COVID-19 by blood tests. The syndrome has been reported weeks after possible COVID-19 infection. How is the syndrome diagnosed? Children with suspected inflammatory response should be evaluated promptly. In addition to a history and physical exami- nation, patients are likely to need X-rays, blood tests, and a nasal swab to test for COVID-19. Some children will need cardiac evaluation with an electrocardiogram and/ or echocardiogram. What is the treatment? Children may require close monitoring in the pediatric intensive care unit. The primary means of treatment is supportive care, includ- ing IV fluids, oxygen, or respiratory support, and medications that support blood pres- sure. In addition, several medications that are commonly used to treat Kawasaki disease and toxic shock syndrome are being used to treat this inflammatory syndrome, including intravenous immunoglobulin, steroids, and medications that alter the immune response.