What?s the Strange Ailment Affecting Kids With Covid-19?

Earlier this week, testifying before Congress, Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, suggested policy makers stay “humble” about what we don’t know about Covid-19 and kids.He didn’t say to panic.“I think there’s generalized fear and anxiety because we told people the good news is that this virus doesn’t do anything to children. (Though that raises plenty of other questions about the role of kids in the virus’s transmission.)Still, Burns says the cluster of cases is unusual—unprecedented, even, in her 30 years studying Kawasaki disease and other immune conditions in kids. “I mean, how could we?” Luckily, she says, doctors appear well-equipped to handle it—and might have a lot to learn about the mysteries of rare immune diseases thanks to this surge in cases.Kawasaki disease, with its telltale nagging fever and bouts of inflammation, is easily spotted by doctors. “No one knows what causes Kawasaki disease, but in genetically-predisposed individuals, some kind of immune trigger turns on that cascade of symptoms,” Kim says. Other researchers have found associations with other common viruses, looking at trends in seasonal illness and in the incidence of Kawasaki disease around the globe.“It has to be more than one type of trigger,” says Kevin Friedman, a pediatric cardiologist at Boston Children’s Hospital, which has seen about 15 cases of Kawasaki-like illness with apparent ties to Covid-19, all of whom have done well so far. “It’s too ubiquitous across the world for us to find a single thing.” Different triggers may be associated with different populations of kids, he adds, and could be the result of different genetic predispositions.With all of this uncertainty about triggers, Kim says she wasn’t particularly surprised to see a mystery inflammatory ailment coming on the heels of a novel disease outbreak.