Tackling COVID-19 in Kids

Children respond to COVID-19 differently from adults. They appear to be less susceptible to the virus, and when they do fall ill, symptoms tend to be milder. However, a number of children with COVID-19 have experienced severe cardiovascular complications, leading in some cases to death.

In two recent editorials, University at Buffalo pediatrics researchers have pointed out the importance of treating the disease differently in kids. One of the researchers—Steven Lipshultz­­, A. Conger Goodyear Professor and chair of UB’s Department of Pediatrics—was subsequently tapped to help lead national efforts to establish a patient registry and to develop treatment guidelines for children with COVID-19.

Lipshultz has spent decades researching cardiovascular diseases in children related to viral illnesses and their therapies. More readily available data on pediatric COVID-19, he argues in one editorial, will be critical in determining how to treat these patients—especially in regard to the emergence of a Kawasaki-like syndrome called multisystem inflammatory syndrome in children (MIS-C), which can have devastating effects on the cardiovascular system and other organs.

Lipshultz goes on to advocate for the creation of pediatric registries, similar to what he and colleagues have done in the field of pediatric cardiomyopathy. Those registries have cut by half the incidence of failure of certain medical interventions.

Another editorial co-authored by Mark Hicar, an assistant professor in UB’s pediatrics department, proposes new guidelines for evaluating children with COVID-19 who exhibit symptoms of MIS-C, based on a multidisciplinary approach being taken in Western New York.

Such guidelines are necessary, Lipshultz says, because of the complexity of the issues involved in this condition and the possibility of rapid deterioration following initially mild symptoms.

Based on the knowledge and experience exhibited in these two editorials, Lipshultz is now working with the Children’s Cardiomyopathy Foundation to establish, with National Institutes of Health funding, a national registry of children with COVID-19 and cardiovascular complications. In addition, he was asked by the American Heart Association to chair a committee to develop a scientific statement on managing and treating children with cardiomyopathies, including COVID-19.