12 ms·

Post-Covid heart damage in some children: study

145 points by claudeganon 6y ago

beagle3 6y ago
When I checked before, it seemed that Kawasaki incidence dropped to 0, and MIS-C cases had the expected prevalence of Kawasaki - meaning that basically, it was a change in classification and not a new disease (and not necessarily a new condition). But I haven’t been keeping track recently.
- pbhjpbhj 6y ago
  So you consider their differential diagnosis to be wrong. They clearly considered Kawasaki as a comparison too. Could you indicate your source and credentials? Is Kawasaki syndrome already considered a post-viral problem? Are you saying these children had Kawasaki already, or that Covid19 infection causes Kawasaki?
  - beagle3 6y ago
    As I mentioned, I'm no longer keeping track; last I checked was in early May, and at the time the disease was not yet called MIS-C. My sources were google searches. My credentials are in math and engineering, not medicine. However, due to unfortunate personal and family issues, I've read tens of medical papers and found statistical errors in many, maybe most of them -- I have literally saved at least one person from a life of misery based on finding these errors (and got apologies from department heads in two of the world's 10 top hospitals) I don't know if Kawasaki is considered a post viral problem - either officially or unofficially. I did not look at the disease mechanics, only at disease prevalence. Symptoms are close enough (and the disease having a clinical description, NO direct biomarkers) that mis-identification is a real problem and known issue with these kinds of rare diseases. The disease I'm very familiar with, unfortunately, shares a lot with kawasaki - including in how often it is misidentified as some benign condition. It was considered, though never proved, a post-viral autoimmune disease for years -- and likely still is by many doctors -- even though the "post viral" aspect is overwhelmingly a secondary aspect (something has to trigger the immune system, it's sometimes a viral episode, sometimes a vaccine, sometimes spontaneously) > They clearly considered Kawasaki as a comparison too. Kawasaki is a clinically identified disease, as is MIS-C. There's no specific biomarker to say "this is one and not the other". Right now, everything COVID-19 is shiny and well funded, whereas older things are not. > Is Kawasaki syndrome already considered a post-viral problem? As of a few months ago, at least half of the MIS-C cases were, to the best of everyone's knowledge, unrelated to COVID-19. see e.g. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31129-6/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... which summarizes the state-of-the-art of knowledge as of May (The lancet is written in a confusing way, but https://www.dicardiology.com/article/kawasaki-inflammatory-disease-affects-children-covid-19 https://www.dicardiology.com/article/kawasaki-inflammatory-d... is more clear - the relation to COVID-19 is not clear cut) Here's a similar point: Last I checked, a few weeks ago, death from the flu all over the world has gone to zero, though in european countries and most of the US since June, death is as expected (statistically indistinguishable from expected rate of death). Flu death has gone to zero; COVID death exists when non did before. What's more likely - that FLU disappeared overnight but COVID has exactly the same rate of death? Or that both COVID and flu take a toll on the weaker and immune suppresed population (whose size didn't really change), but that the deaths are all attributed to COVID even though part (perhaps a third or half) as attributable to the flu? See e.g. https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav... - despite the April time, it IS up-to-date as of 22-aug, and you can definitely see the COVID death toll in europe on Mar-Jun -- but not anymore. > Are you saying these children had Kawasaki already, or that Covid19 infection causes Kawasaki? It is my belief based on knowledge of diseases OTHER than Kawasaki was that the predisposition was there, just waiting for the trigger, and would likely have erupted sooner or later, because of a flu, another virus, or some vaccine -- autoimmune diseases are often triggered when the immune system goes into high gear but them something goes wrong and they start attacking the body instead. I am not saying they had Kawasaki already -- they obviously did not, because -- by definition -- Kawasaki is a set of symptoms (they did not have). However, I'm hypothesizing that everything was ready for Kawasaki, and something just caused it to erupt. It's also possible that COVID-19 was that trigger, and that it causes a slightly different disease progression than "standard" Kawasaki, although there's no such thing either- these diseases are never textbook cases of "These 10 symptoms == kawasaki", but rather "If we have more than 4 out of this list of 14 then we will label it Kawasaki unless we have a better explanation". I am being vague with specific details of the diseases I am familiar with, so as not to out myself - it's rare enough that everyone involved knows everyone else on a first name basis. (Though as far as anyone's concerned, I might as well be a dog on the internet)
wtt604 6y ago
Just in time for schools going back... Kids are fine... Kids toes blister and go blue... Kids get diarrhea and vomiting... Kids get multiple organ failure... Kids get aneurysms... I don't see the news getting better any time soon, sadly
GhostVII 6y ago
The team reviewed 662 MIS-C cases reported worldwide between Jan. 1 and July 25 So does that mean there are only a total of 662 cases reported worldwide? Because if so, this doesn't seem to be a significant issue. Edit: yes, it seems like there are only a few hundred cases in the US [0], not a significant risk. I've seen this article in a few places and everyone seems to interpret it as saying a significant portion of children have a damaged heart after COVID, which just isn't true. Not a problem with the article, just peoples critical thinking skills. [0] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/infographic-mis-c.html https://www.cdc.gov/coronavirus/2019-ncov/covid-data/infogra...
- officialjunk 6y ago
  the pandemic is not over. information is limited. it is not possible to definitively draw this conclusion yet. it is possible it is significant.
  - dv_dt 6y ago
    The significant observation is that there is a possible pathway from Covid infection to MIS-C...
  - dehrmann 6y ago
    Maybe we're doing what we can, but I wish we were putting more effort into collecting data around mid to long-term effects and their likelihood because not knowing that makes it hard to make informed decisions. My money is on this being between rare and uncommon because I'd expect to hear more specific reports on it. Widespread things surface a lot faster.
  - cm2187 6y ago
    Until there is hard data that shows it is a significant problem, this is just more covid FUD. There are rare complications with pretty much every disease. Doesn’t mean it deserves to be a concern in term of public health.
    - hinkley 6y ago
irq11 6y ago
The title should be changed to reflect the fact that this is an incredibly rare complication. As of late July, only 570 MIS patients total had been reported in the US, per the CDC: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6932e2-H.pdf https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6932e2-H.pdf
- bdcravens 6y ago
  It's a title, not a summary or a value judgment. The conclusions are in the article.
  - rriepe 6y ago
    irq11 is right. This is scaremongering garbage. They can't report on cases or deaths (because those tell the whole story) so they make up this crap. Then scared idiots upvote it. The brainwashing of HN continues...
  - irq11 6y ago
    It is a hacker news rule that titles cannot be clickbait or inflammatory. This title unquestionably is missing critical context, and arguably crosses the line into clickbait.
    - dang 6y ago
      Ok, we've edited the title to try to make it more accurate and neutral.
  - SpicyLemonZest 6y ago
    I don't agree. If I wrote a title saying "Post-flu syndrome severely damages kidneys", that'd carry a clear implication that the typical flu survivor has reason to be concerned about their kidneys.
codethief 6y ago
Don't want to play this down or anything but: > Another finding from the case studies: Almost half of patients who had MIS-C had an underlying medical condition, and of those, half of the individuals were obese or overweight.
- jspash 6y ago
  Well when you consider that just over 30% of the population of the US and the UK are overweight, it's not something to sneeze at.
  - oreaway 6y ago
    30% of the population are obese, and another 30% are overweight. In total, more than 60% are overweight/obese.
- wnevets 6y ago
  >were obese or overweight. Like 60% of America is obese or overweight, that is way over 200 Million Americans [1]. I don't understand why people try to use this to downplay (I'm not saying you are) COVID. [1]https://www.healthline.com/health/obesity-facts#1 https://www.healthline.com/health/obesity-facts#1
  - hervature 6y ago
    I don't think people are trying to downplay COVID but rather "up-play" the effects of obesity that so few people seem to care about
  - oreaway 6y ago
    People downplay it because even when presented with these stats, they picture "overweight/obese" as a stereotypical "fat person" wearing size 55 pants and using a scooter to get around the grocery store. And they think "well I'm not fat, so I don't have anything to worry about." In reality, a significant portion of the people reading this comment probably are "overweight" without even realizing it. "Overweight" is classified by your BMI, and the threshold for "overweight" is much lower than most expect. If you are 5'6" and weigh 155 lbs, you are medically overweight. That's someone who wears size 31 pants and size small t-shirts. Not even close to your stereotypical "fat" person, but according to the statistics: overweight. edit to clarify: I intentionally put "overweight" in quotes to indicate that I am using the medical definition of "overweight", and I am not saying that someone who is 5'6" and 155 lbs is unhealthy, fat, or needs to lose weight. Someone who is 5'6" and 155 lbs is, IMO, on the fitter side of the spectrum, but according to the statistics, still "overweight".
deleted 6y ago
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deleted 6y ago
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zamalek 6y ago
We're destroying their climate and their hearts with continued science denial. Disgusting.
just-juan-post 6y ago
I just realized that Trump supporters and authoritarian lockdown doomers are almost exactly alike. Trump followers ignore all bad news and find bits of good news. Authoritarian lockdown doomers ignore all good news and find the the bits of bad news that fits with their narrative. Scary how much some of you do the exact same thing that "Trump cultists" do.
sradman 6y ago
The paper Multisystem inflammatory syndrome in children: A systematic review [1]: > The literature reports that MIS-C typically manifests 3-4 weeks after SARS-CoV-2 infection. This may explain why many children had positive antibodies to SARS- CoV-2, but negative RT-PCR at the time of MIS-C evaluation. > While children with COVID-19 present with upper respiratory symptoms, MIS-C is distinguishable by fever (100%), vomiting (68.2%), and abdominal pain/diarrhea (73.8%). The abdominal pain in MIS-C can be so severe that in several cases patients were presumed to have appendicitis. Young children seem to be protected from lower respiratory manifestations of COVID-19. My reading of this meta-analysis is that MIS-C is primarily a gastrointestinal manifestation of COVID-19 that has progressed to vascular and other tissues that express ACE2 receptors. Perhaps we are placing too much emphasis on nasopharyngeal swab PCR tests and should consider anal swabs for children with gastrointestinal symptoms. [1] https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30271-6/fulltext https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...
glofish 6y ago
This is one of those titles that pull on the heartstrings ... "oh think of the children" then it turns out it is a complication that affects a vanishingly small segment of the population. Then we use the fear to impose rules that severely affect 100% of the children: for example not letting people go outside or go to school. All part of the relentless propaganda of scaremongering where the weak want everyone to be equally afraid.
- rorykoehler 6y ago
  I don't understand this attitude. It's not about fear it's about precaution. Why does everything have to be so extreme?
  - just-juan-post 6y ago
    If it's truly about precaution and the greater safety of others then you would agree that we should ban alcohol.
    - rorykoehler 6y ago
      No. Alcohol doesn't possess viral properties.
      - username90 6y ago
        Your freedom to buy alcohol results in kids getting beaten and killed by their alcoholic parents. Are you really so selfish that you think beer is more important than kids? /s See, the argument is the same.
        rorykoehler 6y ago
        I don't know if you're being serious or not with your final sentence (the positioning of the /s is throwing me off) but for the people who don't get it there has never been an alcoholic beating or drunk driver that resulted in millions of innocent people dying around the world in such a short period time with millions more suffering from potential long term health problems.
aaron695 6y ago
Or We are talking about the human body a lot more now the media can make a headline. If this is from C19 one imagines many other things we don't care about kids getting also can do it.

145 points by claudeganon 6y ago

When I checked before, it seemed that Kawasaki incidence dropped to 0, and MIS-C cases had the expected prevalence of Kawasaki - meaning that basically, it was a change in classification and not a new disease (and not necessarily a new condition). But I haven’t been keeping track recently.

pbhjpbhj 6y ago
So you consider their differential diagnosis to be wrong. They clearly considered Kawasaki as a comparison too. Could you indicate your source and credentials? Is Kawasaki syndrome already considered a post-viral problem? Are you saying these children had Kawasaki already, or that Covid19 infection causes Kawasaki?
- beagle3 6y ago
  As I mentioned, I'm no longer keeping track; last I checked was in early May, and at the time the disease was not yet called MIS-C. My sources were google searches. My credentials are in math and engineering, not medicine. However, due to unfortunate personal and family issues, I've read tens of medical papers and found statistical errors in many, maybe most of them -- I have literally saved at least one person from a life of misery based on finding these errors (and got apologies from department heads in two of the world's 10 top hospitals) I don't know if Kawasaki is considered a post viral problem - either officially or unofficially. I did not look at the disease mechanics, only at disease prevalence. Symptoms are close enough (and the disease having a clinical description, NO direct biomarkers) that mis-identification is a real problem and known issue with these kinds of rare diseases. The disease I'm very familiar with, unfortunately, shares a lot with kawasaki - including in how often it is misidentified as some benign condition. It was considered, though never proved, a post-viral autoimmune disease for years -- and likely still is by many doctors -- even though the "post viral" aspect is overwhelmingly a secondary aspect (something has to trigger the immune system, it's sometimes a viral episode, sometimes a vaccine, sometimes spontaneously) > They clearly considered Kawasaki as a comparison too. Kawasaki is a clinically identified disease, as is MIS-C. There's no specific biomarker to say "this is one and not the other". Right now, everything COVID-19 is shiny and well funded, whereas older things are not. > Is Kawasaki syndrome already considered a post-viral problem? As of a few months ago, at least half of the MIS-C cases were, to the best of everyone's knowledge, unrelated to COVID-19. see e.g. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31129-6/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... which summarizes the state-of-the-art of knowledge as of May (The lancet is written in a confusing way, but https://www.dicardiology.com/article/kawasaki-inflammatory-disease-affects-children-covid-19 https://www.dicardiology.com/article/kawasaki-inflammatory-d... is more clear - the relation to COVID-19 is not clear cut) Here's a similar point: Last I checked, a few weeks ago, death from the flu all over the world has gone to zero, though in european countries and most of the US since June, death is as expected (statistically indistinguishable from expected rate of death). Flu death has gone to zero; COVID death exists when non did before. What's more likely - that FLU disappeared overnight but COVID has exactly the same rate of death? Or that both COVID and flu take a toll on the weaker and immune suppresed population (whose size didn't really change), but that the deaths are all attributed to COVID even though part (perhaps a third or half) as attributable to the flu? See e.g. https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav... - despite the April time, it IS up-to-date as of 22-aug, and you can definitely see the COVID death toll in europe on Mar-Jun -- but not anymore. > Are you saying these children had Kawasaki already, or that Covid19 infection causes Kawasaki? It is my belief based on knowledge of diseases OTHER than Kawasaki was that the predisposition was there, just waiting for the trigger, and would likely have erupted sooner or later, because of a flu, another virus, or some vaccine -- autoimmune diseases are often triggered when the immune system goes into high gear but them something goes wrong and they start attacking the body instead. I am not saying they had Kawasaki already -- they obviously did not, because -- by definition -- Kawasaki is a set of symptoms (they did not have). However, I'm hypothesizing that everything was ready for Kawasaki, and something just caused it to erupt. It's also possible that COVID-19 was that trigger, and that it causes a slightly different disease progression than "standard" Kawasaki, although there's no such thing either- these diseases are never textbook cases of "These 10 symptoms == kawasaki", but rather "If we have more than 4 out of this list of 14 then we will label it Kawasaki unless we have a better explanation". I am being vague with specific details of the diseases I am familiar with, so as not to out myself - it's rare enough that everyone involved knows everyone else on a first name basis. (Though as far as anyone's concerned, I might as well be a dog on the internet)

wtt604 6y ago

Just in time for schools going back... Kids are fine... Kids toes blister and go blue... Kids get diarrhea and vomiting... Kids get multiple organ failure... Kids get aneurysms... I don't see the news getting better any time soon, sadly

GhostVII 6y ago

The team reviewed 662 MIS-C cases reported worldwide between Jan. 1 and July 25 So does that mean there are only a total of 662 cases reported worldwide? Because if so, this doesn't seem to be a significant issue. Edit: yes, it seems like there are only a few hundred cases in the US [0], not a significant risk. I've seen this article in a few places and everyone seems to interpret it as saying a significant portion of children have a damaged heart after COVID, which just isn't true. Not a problem with the article, just peoples critical thinking skills. [0] https://www.cdc.gov/coronavirus/2019-ncov/covid-data/infographic-mis-c.html https://www.cdc.gov/coronavirus/2019-ncov/covid-data/infogra...

officialjunk 6y ago
the pandemic is not over. information is limited. it is not possible to definitively draw this conclusion yet. it is possible it is significant.
- dv_dt 6y ago
  The significant observation is that there is a possible pathway from Covid infection to MIS-C...
- dehrmann 6y ago
  Maybe we're doing what we can, but I wish we were putting more effort into collecting data around mid to long-term effects and their likelihood because not knowing that makes it hard to make informed decisions. My money is on this being between rare and uncommon because I'd expect to hear more specific reports on it. Widespread things surface a lot faster.
- cm2187 6y ago
  Until there is hard data that shows it is a significant problem, this is just more covid FUD. There are rare complications with pretty much every disease. Doesn’t mean it deserves to be a concern in term of public health.
  - hinkley 6y ago

irq11 6y ago

The title should be changed to reflect the fact that this is an incredibly rare complication. As of late July, only 570 MIS patients total had been reported in the US, per the CDC: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6932e2-H.pdf https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6932e2-H.pdf

bdcravens 6y ago
It's a title, not a summary or a value judgment. The conclusions are in the article.
- rriepe 6y ago
  irq11 is right. This is scaremongering garbage. They can't report on cases or deaths (because those tell the whole story) so they make up this crap. Then scared idiots upvote it. The brainwashing of HN continues...
- irq11 6y ago
  It is a hacker news rule that titles cannot be clickbait or inflammatory. This title unquestionably is missing critical context, and arguably crosses the line into clickbait.
  - dang 6y ago
    Ok, we've edited the title to try to make it more accurate and neutral.
- SpicyLemonZest 6y ago
  I don't agree. If I wrote a title saying "Post-flu syndrome severely damages kidneys", that'd carry a clear implication that the typical flu survivor has reason to be concerned about their kidneys.

codethief 6y ago

Don't want to play this down or anything but: > Another finding from the case studies: Almost half of patients who had MIS-C had an underlying medical condition, and of those, half of the individuals were obese or overweight.

jspash 6y ago
Well when you consider that just over 30% of the population of the US and the UK are overweight, it's not something to sneeze at.
- oreaway 6y ago
  30% of the population are obese, and another 30% are overweight. In total, more than 60% are overweight/obese.
wnevets 6y ago
>were obese or overweight. Like 60% of America is obese or overweight, that is way over 200 Million Americans [1]. I don't understand why people try to use this to downplay (I'm not saying you are) COVID. [1]https://www.healthline.com/health/obesity-facts#1 https://www.healthline.com/health/obesity-facts#1
- hervature 6y ago
  I don't think people are trying to downplay COVID but rather "up-play" the effects of obesity that so few people seem to care about
- oreaway 6y ago
  People downplay it because even when presented with these stats, they picture "overweight/obese" as a stereotypical "fat person" wearing size 55 pants and using a scooter to get around the grocery store. And they think "well I'm not fat, so I don't have anything to worry about." In reality, a significant portion of the people reading this comment probably are "overweight" without even realizing it. "Overweight" is classified by your BMI, and the threshold for "overweight" is much lower than most expect. If you are 5'6" and weigh 155 lbs, you are medically overweight. That's someone who wears size 31 pants and size small t-shirts. Not even close to your stereotypical "fat" person, but according to the statistics: overweight. edit to clarify: I intentionally put "overweight" in quotes to indicate that I am using the medical definition of "overweight", and I am not saying that someone who is 5'6" and 155 lbs is unhealthy, fat, or needs to lose weight. Someone who is 5'6" and 155 lbs is, IMO, on the fitter side of the spectrum, but according to the statistics, still "overweight".

deleted 6y ago

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deleted 6y ago

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zamalek 6y ago

We're destroying their climate and their hearts with continued science denial. Disgusting.

just-juan-post 6y ago

I just realized that Trump supporters and authoritarian lockdown doomers are almost exactly alike. Trump followers ignore all bad news and find bits of good news. Authoritarian lockdown doomers ignore all good news and find the the bits of bad news that fits with their narrative. Scary how much some of you do the exact same thing that "Trump cultists" do.

sradman 6y ago

The paper Multisystem inflammatory syndrome in children: A systematic review [1]: > The literature reports that MIS-C typically manifests 3-4 weeks after SARS-CoV-2 infection. This may explain why many children had positive antibodies to SARS- CoV-2, but negative RT-PCR at the time of MIS-C evaluation. > While children with COVID-19 present with upper respiratory symptoms, MIS-C is distinguishable by fever (100%), vomiting (68.2%), and abdominal pain/diarrhea (73.8%). The abdominal pain in MIS-C can be so severe that in several cases patients were presumed to have appendicitis. Young children seem to be protected from lower respiratory manifestations of COVID-19. My reading of this meta-analysis is that MIS-C is primarily a gastrointestinal manifestation of COVID-19 that has progressed to vascular and other tissues that express ACE2 receptors. Perhaps we are placing too much emphasis on nasopharyngeal swab PCR tests and should consider anal swabs for children with gastrointestinal symptoms. [1] https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30271-6/fulltext https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

glofish 6y ago

This is one of those titles that pull on the heartstrings ... "oh think of the children" then it turns out it is a complication that affects a vanishingly small segment of the population. Then we use the fear to impose rules that severely affect 100% of the children: for example not letting people go outside or go to school. All part of the relentless propaganda of scaremongering where the weak want everyone to be equally afraid.

rorykoehler 6y ago
I don't understand this attitude. It's not about fear it's about precaution. Why does everything have to be so extreme?
- just-juan-post 6y ago
  If it's truly about precaution and the greater safety of others then you would agree that we should ban alcohol.
  - rorykoehler 6y ago
    No. Alcohol doesn't possess viral properties.
    - username90 6y ago
      Your freedom to buy alcohol results in kids getting beaten and killed by their alcoholic parents. Are you really so selfish that you think beer is more important than kids? /s See, the argument is the same.
      - rorykoehler 6y ago
        I don't know if you're being serious or not with your final sentence (the positioning of the /s is throwing me off) but for the people who don't get it there has never been an alcoholic beating or drunk driver that resulted in millions of innocent people dying around the world in such a short period time with millions more suffering from potential long term health problems.

aaron695 6y ago

Or We are talking about the human body a lot more now the media can make a headline. If this is from C19 one imagines many other things we don't care about kids getting also can do it.