“We really don’t know what will happen in the long term,” said Dr. Jean Ballweg, medical director of pediatric heart transplant and advanced heart failure at Children’s Hospital & Medical Center in Omaha, Nebraska, where from April through October, the hospital treated about two cases a month, about 30% of them in the ICU. That rose to 10 cases in December and 12 in January, with 60% needing ICU care — most requiring ventilators. “Clearly, they seem to be more sick,” she said.
Symptoms of the syndrome can include fever, rash, red eyes or gastrointestinal problems. Those can progress to heart dysfunction, including cardiogenic shock, in which the heart cannot squeeze enough to pump blood sufficiently. Some patients develop cardiomyopathy, which stiffens the heart muscle, or abnormal rhythm. Ballweg said one 15-year-old at her hospital needed a procedure that functioned as a temporary pacemaker.
Hospitals say most patients test positive for el bichito antibodies that indicate previous infection, but some patients also test positive for active infection. Many children were previously healthy and had few or no symptoms from their initial el bichito infection.