An ambulance drives across a nearly empty East 42nd Street in heavy rain and high winds in Manhattan during the outbreak of the coronavirus disease (COVID-19) in New York City, April 13, 2020.

Mike Segar/Reuters

15 children were hospitalized in New York City with an unknown disease, according to the city’s Department of Health.

Symptoms of the disease were similar to toxic shock or Kawasaki disease, with inflammation of the blood vessels.

In the past week, reports have been circulating about 100 children, mainly in Europe, who had similar symptoms.

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In New York City, the epicenter of the COVID-19 in the United States, 15 children were recently hospitalized with a disease doctors still haven’t identified. There are concerns, not yet substantiated, that it could be linked to the novel coronavirus.

The children were between the ages of two and 15 and reported vomiting, abdominal pain, and diarrhea. Over half of them needed blood pressure support and five needed mechanical ventilation.

The diagnoses, reported Monday by the New York City Department of Health, follow reports that 100 children, mostly in European countries, have been treated in hospital for a similar condition.

The symptoms included inflammation of the blood vessels, and seemed to be associated with Kawasaki disease, a rare illness that occurs in one in 10,000 children under the age of five every year. Other symptoms of Kawasaki disease include swollen hands and feet, bright red swollen lips and rashes on the torso or groin.

In the report, health officials warned city doctors to look out for the condition currently being described as “multi-system inflammatory syndrome,” and suggested ICU admission for cardiac or respiratory support may be required. There have been no reports of any deaths connected to this condition.

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Cases around the world

There is no proof that this syndrome is linked to COVID-19, and it still remains exceedingly rare. Nonetheless, the World Health Organization warned its clinical network to be alert for new cases in children.

As was the case with SARS, adults seem to be harder-hit by the new coronavirus than children. According to the CDC, only 1.7% of American COVID-19 cases occurred in children, and most of those cases have been mild. 

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But the timing of this small cluster of pediatric cases has given health officials pause.

In Europe, doctors have reported the same confounding condition across a number of hard-hit countries.

In Bergamo, a town in northern Italy, there are 20 purported cases at the Papa Giovanni XXIII hospital. Twelve children in the UK, who all reported the same Kawasaki-like symptoms, had to be placed in intensive care, according to the Guardian. Cases have also been reported in France, Switzerland, and Spain.

Kawasaki syndrome was poorly understood even before the coronavirus pandemic, but seems to be triggered by viruses or infections, as Business Insider’s Mia Jankowicz previously reported. “Kawasaki syndrome does not have a precise cause, but in genetically predisposed children there is a triggering environmental factor, probably infectious and probably viral,” pediatrician Dr Marianna Fabi, who is treating five cases at Bologna’s Sant’Orsola-Malpighi hospital, told Il Corriere Della Sera.

New York City health officials are studying a possible link with COVID-19

New York City’s health commissioner Dr. Oxiris Barbot said doctors must alert the health department if they see children with these symptoms.

Barbot told the New York Times that “even though the relationship of this syndrome to COVID-19 is not yet defined, and not all of these cases have tested positive for COVID-19 by either DNA test or serology, the clinical nature of this virus is such that we are asking all providers to contact us immediately if they see patients who meet the criteria we’ve outlined.”

Mount Sinai hospital in New York confirmed some of its pediatric patients have been experiencing these symptoms. “While it is too early to definitively say what is causing this we believe it is important to alert the public as to what we are seeing,” Dr. George Ofori, Pediatric Critical Care Director at Mount Sinai Kravis Children’s Hospital, told NBC News.

Dr. James Schneider, Director of Pediatric Critical Care at Cohen Children’s Hospital in Nassau, also told NBC his hospital has about 12 patients with similar symptoms. “It’s something we’re starting to see around the country,” Schneider said. 

Parents are being urged to take children with high fever, rashes, or stomach pains to the doctor immediately.

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