A new study of young COVID-19 patients hospitalized with a rare condition at Cohen Children’s Medical Center in New Hyde Park showed that neurological, psychological and sleep complications were common and in some cases persisted for weeks after they were discharged.
The children in the study, conducted by Northwell Health’s Feinstein Institutes for Medical Research, were hospitalized with multisymptom inflammatory syndrome (MIS-C) in 2020.
The condition, which can be serious or even deadly, emerges in some children weeks after being infected with COVID-19. It can cause inflammation in the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.
Dr. Sanjeev Kothare, director of the Division of Pediatric Neurology at Cohen Children’s Medical Center and lead researcher on the study, said, anecdotally, he was also seeing other young patients who, after having the virus, had similar complications.
"They were not sleeping well at night, had brain fog during the day, excessive daytime sleepiness, headaches and mood disturbances," Kothare said.
He focused the study on determining if COVID-19 patients who were hospitalized with MIS-C came in with or developed these symptoms. The study included 47 patients, 18 years of age and younger, who were hospitalized with MIS-C between March 2020 and August 2020, during the first wave of the COVID-19 pandemic and before the COVID-19 vaccination was available.
They interviewed patients and their families to determine if these symptoms were present when the child was admitted to the hospital, during their stay and when they returned home, following up for about five months.
Kothare and his team found that 77% of patients reported neurological, 60% psychiatric and 77% sleep symptoms during hospitalization.
Fifty percent of the patients who had neurological symptoms during hospitalization continued to have symptoms on follow-up, 57% of patients with psychiatric symptoms reported persistence at follow-up and 42% of the 18 patients who reported sleep disturbance during hospitalization still had problems weeks later.
Kothare said in a few cases, the MIS-C patients had come in with existing neurological, sleep and psychiatric issues that were exacerbated by COVID-19.
"This is such an important study, in that this cohort of children, who are apparently cured after MIS-C, went on to have more subtle, but persistent medical issues," said Dr. Charles Schleien, senior vice president and chair of Pediatric Services at Northwell Health. "For parents who believe that children are generally unaffected by COVID, this paper illustrates that children can be affected in more subtle ways than previously appreciated."
According to the CDC, there have been 6,431 MIS-C cases and 55 deaths from the illness across the United States since the start of the pandemic. About half of the cases are found in children between the ages of 5 and 13 but it can impact infants and older teens. Since MIS-C emerges three to five weeks after COVID-19 infection, doctors on Long Island said they are on high alert for any signs among children since it's been several weeks since the omicron wave of COVID-19 peaked.
Kothare said the study shows that awareness is key for doctors treating MIS-C patients and other children who had the virus. He said during hospital admission, the treating physicians should ask about sleep issues, mood changes, brain fog and other symptoms.
"If they’re present, they should provide guidance, preventive measures, even symptomatic care and follow them through," he said. "And even after discharge, if they have a mood disturbance address it right away with antidepressants and anti-anxiety, drugs. If they have sleep problems, do a sleep hygiene and schedule … if they have headaches, use anti headache, medications."