Multisystem Inflammatory Syndrome in Children: Dr. Sanjay Gupta’s podcast for May 20

Health officials in Europe and the United States have reported cases of a rare but serious new syndrome affecting children. CNN Chief Medical Correspondent Dr. Sanjay Gupta talks to doctors investigating the condition and to a young girl who has recovered from it.

You can listen on your favorite podcast app or read the transcript below.

MSNBC: Doctors are seeing an increase in what’s being called multisystem inflammatory syndrome in children.

Jack McMorrow, 14-year-old patient: It felt like almost electricity or fire coursing through my veins.

CNN: It’s been seen in children across Europe. It’s been in at least 18 states now plus Washington, DC.

Dr. Sanjay Gupta: In the last few months, health officials in Europe and the United States have begun looking into a new condition affecting children.

Children are showing up in hospitals with severe inflammation and poor function in some of their organs — including their kidneys and heart.

It’s particularly surprising because in most cases these children were seemingly healthy without any underlying conditions before they developed this syndrome.

So, in this episode, I’m going to explore what we currently know about the new syndrome and how doctors are treating it, and also what it was actually like for one little girl and her family.

I’m Dr. Sanjay Gupta, CNN’s chief medical correspondent. And this is “Coronavirus: Fact vs. Fiction.”

Now, as a father myself, I want to start off by reassuring parents that this condition we’re talking about today remains rare for the time being. To date, there have been fewer than 200 reported patients in the United States who doctors are still investigating.

The CDC [US Centers for Disease Control and Prevention] is calling it multisystem inflammatory syndrome in children, or MIS-C for short.

There is still a lot we’re figuring out about it. Why are just some children getting sick? Why now, months into this pandemic? And what exactly is causing it?

One thing that many of them have in common is that they tested positive for Covid-19. Experts say it could be a post-viral syndrome. That means it may not be directly caused by Covid-19, but it could be a response by the patient’s immune system.

To learn more about the symptoms and how the syndrome is treated, I reached out to 12-year-old Juliet Daly, one of the first patients treated for the syndrome in the United States.

I spoke to her and her father, Sean, from their home in Louisiana.

Sean Daly: Hello!

Juliet Daly: Hello!

Gupta: Juliet, let me start with you. When did you first start to not feel well?

Juliet: Well, it was about … it was Friday. I woke up in the morning. My stomach started to hurt pretty bad. And it felt like my legs were weak and I was pretty tired.

Sean: So Friday she wasn’t feeling well, but she sort of made it through the day. Sunday she was nauseous. She was throwing everything up, even water. And we became pretty concerned that day and sort of had that in our mind that if this continued through Monday, you know, we were gonna take her into the pediatrician.

So Monday came around. She started having blue lips and her extremities were cold. So that’s when it was like, this is not a, you know, normal flu.

Gupta: So what do you do next?

Sean: So we called her pediatrician, and they talked to us on the phone. But then it sounded serious enough to bring her in. So we went in. He saw her very quickly, very quickly decided this is something different. You know, she’s sicker than normal.

So had us go across the street to the ER where, you know, they could run some tests, essentially. And that’s when we sort of, everything started cascading.

Gupta: It turned out Juliet’s oxygen levels were low. Her heart wasn’t pumping blood to the rest of her body very well. Doctors decided to intubate her and then airlift her to a different hospital — a nearby ICU that was better staffed to treat her. On that journey, she went into cardiac arrest and was resuscitated twice.

Dr. Jake Kleinmahon, medical director of pediatric heart transplant and heart failure, Ochsner Hospital for Children: She was about as close to death as you can get.

Gupta: That’s Dr. Jake Kleinmahon, a pediatric cardiologist at Ochsner Hospital for Children. He treated Juliet when she got to the ICU. Juliet tested positive for Covid-19.

Kleinmahon: Her heart was barely squeezing. She was going into kidney failure, liver failure.

Gupta: It is believed that MIS-C is caused by the immune system acting in overdrive — the body’s own defenses overreacting. And that can lead to inflammation in several organs in the body. So to treat Juliet, Dr. Kleinmahon gave her a medication that reduced the inflammation in her heart, her lungs and her kidneys.

Kleinmahon: So those medicines, they stop the cell signaling for inflammation and for the inflammatory process. And the hope is that if we can calm everything down in the body, we can give the body a chance to recover naturally.

Gupta: Thankfully, the treatment was effective. After four days, Juliet’s lungs began to function normally again. She was taken off the ventilator. And for the first time since her air transport, was able to talk to her parents.

Sean: When she first woke up, she wanted water and then she wanted my wife to tell her teachers that she was in the hospital. She was like, “They know.”

Gupta: Juliet appears to have made a full recovery. After 10 days in the hospital, she was able to go home and get back to online school.

Juliet: Well, I’m feeling good.

Gupta: Are you back 100 percent would you say? Back to normal?

Juliet: Well, I still feel a bit out of place. Feel kind of 99%.

Sean: Yeah, we’ll take 99%.

Gupta: Well, I’m glad you’re 99%, and I’m sending you good energy to get you to a 100%. OK?

Sean: Yeah. I mean, she said 98% two days ago. So we’re going in the right direction.

Gupta: This new syndrome, MIS-C, has been compared to toxic shock syndrome, and another rare inflammatory disease that affects young children called Kawasaki disease.

Dr. Jane Burns, director, Kawasaki Disease Research Center, University of California, San Diego: Kawasaki disease is a very visual disease.

Gupta: Dr. Jane Burns is the director of the Kawasaki Disease Research Center at the University of California, San Diego.

Burns: Children develop high fever and in conjunction with the fever, various things turn red. So they get bloodshot eyes, red cracked lips and tongue, rash over the body, red palms and soles and swollen hands and feet.

Gupta: Some MIS-C patients have had symptoms that look similar. But doctors are still not sure if there’s a link.

Burns: We certainly don’t know at this point in time that this new very severe cardiovascular collapse that we’re seeing is related to Kawasaki disease. We do not know that. We are certainly trying to investigate and understand if there is a relationship, because that leads us then to knowing more about how to treat it.

Gupta: Hearing about all this can be overwhelming. But the good news is that doctors say treatment has largely been effective.

If you’re a parent, keep an eye out for any unusual symptoms in your child — abdominal pain, vomiting or fever that is lasting for days or any red rashes on the body. You know your kids best. If they aren’t acting like their normal selves, call your pediatrician.

I think it’s a good idea to set up a communication line with your pediatrician now via telehealth, even if you don’t need them right now. That could save you a visit to the hospital in the future, which is certainly a good idea in the midst of a pandemic.

Now, like I said, there’s still a lot that we are learning about this syndrome. One of the big questions that remains is what is the link to Covid-19?

Just as we have been learning and treating coronavirus at the same time, we’re going do the same with this new syndrome.

After all, this is a new disease we’re seeing unfold in real time. And as we’ve always said, we’re learning together. All of us.

We’ll be back tomorrow. Thanks for listening.