Parents and doctors around the world have expressed fears over a severe inflammatory syndrome in children that some have tied to the covid-19 pandemic. But doctors in Pittsburgh stress there is not enough information to be alarmed.

The condition, called multisystem inflammatory syndrome, is comparable to Kawasaki Syndrome, a rare disease that causes a long list of symptoms — high fever, rash, conjunctivitis, swollen glands, bloodshot eyes, dry and cracked lips. Kawasaki also tends to affect the coronary arteries that control blood flow in the middle of the heart, where blockages can cause a heart attack.

“We have cared for kids with Kawasaki disease, and conditions like Kawasaki disease, for literally decades,” said Dr. Terry Dermody, a virologist and physician-in-chief and scientific director at UPMC Children’s Hospital of Pittsburgh. “Despite years and years of searching for a cause, we’ve not come up with any certain link to Kawasaki disease, any infectious trigger. We all suspect that there is one, but we haven’t been able to identify it.”

Outbreaks of the new syndrome have been spotted in high-population areas that are hot spots of the coronavirus, including New York City, Milan and London. At least 17 states and Washington, D.C., also are checking into suspected cases, according to a CNN survey.

Those with recorded cases have said the children also tested positive for either covid-19 or for covid-19 antibodies, meaning they had the virus and recovered.

Dermody said Kawasaki typically manifests in toddlers, but multisystem inflammatory syndrome is appearing in older children.

There are other distinctions to the new syndrome, as patients don’t always experience all of the same symptoms of Kawasaki.

Dr. Sara Springer, a primary care provider at Kids Plus Pediatrics in Squirrel Hill, said the new syndrome also seems to have a greater effect on a child’s blood pressure, causing it to gradually decline.

But the Pittsburgh doctors say there is still no proof directly linking the new syndrome to covid-19.

“We’re really still in our infancy of understanding this infection,” Springer said. “And our testing is still unsure, so we don’t have testing capacity that’s really well-validated. Are those positives true positives, and are those negatives true negatives? We don’t exactly know the answer yet.”

In addition to the unreliability of tests, Dermody said Kawasaki is a condition often triggered in children with aggressive immune systems: Once their bodies sense a virus or germ, it starts to react in an effort to protect itself, spurring the severe symptoms. It’s possible that covid-19 is not a cause for the syndrome, just a “tripwire,” Dermody said. It could easily be caused by any other severe virus the child is exposed to.

“Some children have an overactive inflammatory response, so that when they’re exposed to particular viruses or other germs, it becomes hyperactive. So that even when the germ is long gone, it’s as if the body senses there is still some invasion,” he said.

Dermody said the covid-19 pandemic may have just created a landscape that is “hyper-sensitive” to new and unknown viruses. Perhaps multisystem inflammatory syndrome appears to be related to covid-19 only because it emerged around the same time, he said. There is no way to know for sure until more research is conducted.

“It’s brand-new, and of course the world is very intensely focused on this virus,” he said. “That intense scrutiny that covid-19 has really engendered has led everybody to be suspicious — ‘could there be anything else that might be associated with this virus?’ ”

At this point, both Kawasaki and the new syndrome are a rarity, Springer said, and parents should not be alarmed. First off, symptoms are so severe and obvious that it will be easy for parents to spot early on.

“This is not subtle, and it’s not a secretive thing that sneaks up on you,” Springer said. “You don’t miss this.”

Springer added that parents should still make sure their children are practicing social distancing in relation to covid-19 though, as there is still a risk they can become infected or carry it to a parent or grandparent.

“But we don’t need to lie awake at night worrying that something horrible is going to happen to their child,” she said.

Dermody also emphasized that the majority of children who are affected by Kawasaki Syndrome recover with little to no lasting damage. Patients are normally treated with immunoglobulin, a pool of antibodies that acts as a potent anti-inflammatory and quickly eases symptoms.

Even if a causal link is proven between the syndrome and covid-19, few children have been affected by the coronavirus in Western Pennsylvania. Statewide, fewer than than 2% of children younger than 12 have tested positive for covid-19, and there have been no instances of multisystem inflammatory syndrome associated with covid-19 in the region.

Dermody said Children’s Hospital has tested nearly 300 patients who arrived showing symptoms consistent with covid-19; of those, only three came out positive. All three children were treated and are recovering at home, he said.

The more pressing fear for medical professionals, Springer and Dermody said, is the way many parents have halted routine medical care for their children out of fear of catching the virus. Both doctors have seen decreases in routine visits with their young patients.

Dermody said he is most worried about children with chronic conditions whose health has worsened as they’ve delayed care. At Children’s Hospital, Dermody said he has seen children whose cancer diagnoses were delayed because they didn’t come in sooner.

“Our facility has got to be the safest place on the planet Earth,” he said. “I can’t imagine a safer place to be.”

Springer fears that parents will neglect to get their children up-to-date on vaccinations as they avoid doctor’s offices.

“What we’re seeing right now, worldwide, is what the world looks like without a vaccine and without herd immunity,” Springer said. “We really want to make sure kids are still getting their vaccines because as things do gradually open up and kids go back to school and child care, we do not want to be dealing with outbreaks of meningitis or whooping cough or measles — which are much more severe for kids than the coronavirus.”

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