Editor’s note: The Salt Lake Tribune is providing free access to critical stories about the coronavirus. Sign up for our Top Stories newsletter, sent to your inbox every weekday morning. To support journalism like this, please donate or become a subscriber.
Madilyn Dayton had been feeling sick for a couple of days when she woke up frozen in bed.
“I couldn’t move at all,” the 12-year-old said. “My head, I couldn’t move it from side to side. It was just stuck.”
Her mother, Marilyn, was mystified — and later stunned to learn, in the intensive care unit of Primary Children’s Hospital, that her daughter had developed a serious inflammatory syndrome that appears in some children a few weeks after they are infected with COVID-19.
“I was shocked," Marilyn Dayton said in a news conference Monday. Nobody in her family had tested positive for the coronavirus, or even had felt sick. ”I thought I was taking precautions; I thought I was doing the best I could to protect my family."
As coronavirus cases proliferate around Utah, doctors at Primary Children’s say they are seeing more and more of this illness — at least 20 cases as of Monday — and it is casting doubt over the widespread belief that COVID-19 is almost never serious in children.
The kids who develop the subsequent illness, known as multisystem inflammatory syndrome in children, or MIS-C, are averaging six days in the hospital, with five of them spent in the ICU, said Dr. Erin Treemarcki, a pediatric rheumatologist at Primary Children’s.
It most frequently affects children’s hearts, with a cascade of exaggerated immune responses often leading to enlarged arteries, low blood pressure and diminishing heart function, said Dr. Dongngan Truong, a pediatric cardiologist at the hospital.
While doctors at Primary Children’s say the patients there appear to have responded well to anti-inflammatory drugs and other treatments, they don’t know the long-term effects.
Nearly three weeks after she was admitted, Madilyn still isn’t able to return to her school in Cokeville, Wyo. And she’s sitting out basketball season.
“We have kids with MIS-C stopping all competitive sports [and other strenuous activity] for three to six months to avoid scarring of the heart,” Truong said.
[Read more: Complete coverage of the coronavirus]
Several new children were admitted for the illness this weekend, said Dr. Jason Lake, a pediatric infectious disease specialist at the hospital, with many more expected in coming weeks. The symptoms of MIS-C — fever, rash, stomach ache, vomiting, eye redness — typically don’t appear until four to six weeks after infection.
“We believe in coming weeks," Lake said, “we will more than double the cases we have seen thus far today.”
But it’s hard to know just how widespread the illness will be. With 1,971 new coronavirus cases reported Monday, Utah’s rate of new diagnoses plateaued after a lull in test results that is typical each week.
But about one in four tests are coming back positive, which means a lot of Utahns with COVID-19 likely have not been diagnosed and may be unwittingly spreading the virus.
Meanwhile, Utah’s coronavirus hospitalizations continued to skyrocket Monday, after a record number of deaths for the week.
The Utah Department of Health on Monday reported a seven-day average of 2,949 new positive test results per day — slightly below Sunday’s rate of 2,985, but far above the previous Monday’s, 2,460.
Utah’s death toll from the coronavirus stood at 723 on Monday, with five fatalities reported since Sunday, marking the virus’s deadliest week in the state since the pandemic began:
- A Box Elder County man, age 65 to 84.
- Two Salt Lake County men, one age 45 to 64 and the other over age 85.
- A Utah County woman, age 65 to 84.
- A Washington County woman, older than 85.
Hospitalizations continued to rise Monday, with a record 503 Utah patients concurrently admitted, UDOH reported.
In total, 6,859 patients have been hospitalized in Utah for COVID-19, with nearly 700 Utahns admitted to hospitals in the past week.
Those patients mostly are over 45 — children under 14 account for less than 1% of Utah’s hospital admissions for COVID-19.
But when MIS-C sets in, Treemarcki said, the illness is urgent.
“I woke up and I had a really bad headache, and body aches all over,” Madilyn Dayton said. “Two or three days later, I couldn’t walk and wouldn’t eat.”
Then rashes appeared on her body, she said. And the next day her mother heard her screaming from her bedroom that she couldn’t move.
The U.S. Centers for Disease Control and Prevention recommends that parents call children’s doctor if they develop fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes or fatigue. Seek emergency care if they are experiencing trouble breathing, unrelenting pain or pressure in the chest, unusual confusion, severe abdominal pain, bluish color in the lips or face, or they are unable to stay awake.
Because the symptoms mimic other illnesses, from appendicitis to Kawasaki syndrome, parents may not immediately recognize it — especially because it can occur in children whose COVID-19 infections may have gone undetected.
For the past week, 24.6% of all tests have come back positive — a record-high rate that indicates a large number of infected people are not being tested, state officials have said.
The virus appears to be ravaging parts of rural Utah. The Tri-County area of eastern Utah reported the state’s highest number of coronavirus hospitalizations per capita — even higher than Salt Lake County, which has the largest share of the state’s nursing homes.
Meanwhile, the highest infection rates for the past two weeks are in Sevier County, where cases appear to have mushroomed during the weekend, according to county data. But the number of new cases per capita are nearly as high in Utah and Garfield counties. In all three of those counties, more than one in every 70 residents have tested positive for COVID-19 in the past two weeks.
But the worst outbreak remains in the northern neighborhoods of Orem, where more than one in every 44 people has tested positive in the past two weeks.
Only about 9,500 test results were reported on Monday, well below the weeklong average of about 12,300 new tests per day.