The state Department of Health is investigating several cases of severe illness in children and child deaths that may be related to COVID-19.

There have been 73 reported cases in New York where children are experiencing symptoms similar to Kawasaki disease and toxic shock-like syndrome possibly due to COVID-19, and on Thursday a 5-year-old boy passed away in New York City from COVID-related complications. Gov. Andrew Cuomo has directed the state Department of Health to work with the CDC to develop a case definition for this illness to determine whether the remaining cases under investigation are definitively associated with the syndrome.

At Cuomo’s direction, the state Department of Health has issued an advisory about this serious inflammatory disease, called “Pediatric Multi-System Inflammatory Syndrome Associated with COVID-19,” to inform healthcare providers of the condition, as well as to provide guidance for testing and reporting. Health care providers, including hospitals, are required to report to the Department of Health all cases of pediatric multisystem inflammatory syndrome potentially associated with COVID-19 in those under 21 years of age.

New Yorkers should seek immediate care if a child has:

¯ Prolonged fever (more than five days);

¯ Difficulty feeding (infants) or is too sick to drink fluids;

¯ Severe abdominal pain, diarrhea or vomiting;

¯ Change in skin color – becoming pale, patchy and/or blue;

¯ Trouble breathing or is breathing very quickly;

¯ Racing heart or chest pain;

¯ Decreased amount of frequency in urine; and

¯ Lethargy, irritability or confusion

“There’s still so much we don’t know about COVID-19, and in the beginning we were led to believe that the good news about this virus was it didn’t affect children,” Cuomo said. “Now we have a new issue that we’re looking at where some children affected with the COVID-19 virus are becoming ill with symptoms similar to the Kawasaki disease or toxic shock-like syndrome. This would be really painful news and would open up an entirely different chapter in our fight against this virus, and the State Department of Health is currently investigating these cases to learn more. In the meantime, we are cautioning all people to look out for the symptoms of this serious illness and to seek help immediately if your child is sick.”

Though most children who get COVID-19 experience only mild symptoms, in the United Kingdom, a possible link has also been reported between pediatric COVID-19 and serious inflammatory disease. The inflammatory syndrome has features which overlap with Kawasaki disease and toxic shock syndrome and may occur days to weeks after acute COVID-19 illness. It can include persistent fever, abdominal symptoms, rash, and even cardiovascular symptoms requiring intensive care.

Early recognition by pediatricians and referral to a specialist including to critical care is essential. Molecular and serological testing for COVID-19 in children exhibiting the above symptoms is recommended. The majority of patients have tested positive for COVID-19, some on molecular testing for SARS-COV-2, others on serological testing.