CORONAVIRUS

Iowa 8-year-old with post-COVID-19 syndrome recovering well, family says

St. Luke's doctor concerned for new cases as infection rate rises

Fortune Djagni, 8, is cheered May 22 by hospital staff as he leaves with his father, Kokou Djagni, from the UnityPoint H
Fortune Djagni, 8, is cheered May 22 by hospital staff as he leaves with his father, Kokou Djagni, from the UnityPoint Health St. Luke’s Center for Women’s and Children’s Health in Cedar Rapids. Fortune was the first patient in Iowa diagnosed with pediatric multisystem inflammatory syndrome, also known as multisystem inflammatory syndrome in children, which is a rare syndrome that develops after COVID-19 infection has passed. (Liz Martin/The Gazette)
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CEDAR RAPIDS — Two months after battling a rare, yet possibly life-threatening post-COVID-19 condition, an 8-year-old Cedar Rapids boy is back to his normal self.

In the midst of his summer off, Fortune Djagni has been playing with his older brother and reading through a third-grade learning curriculum guide given to him by his parents. He’s proud to say he’s already on week seven of 36.

And, to his parents’ relief, he has recovered from his illness.

“I’ve been feeling pretty healthy,” Fortune said.

Fortune was the first child in Iowa to be diagnosed with multisystem inflammatory syndrome, a rare inflammatory condition that affects the hearts and other organs in children and adolescents. The syndrome, which has been compared to toxic shock syndrome and Kawasaki disease, appears in young patients following an infection of the novel coronavirus.

The state’s first two cases — Fortune and a now-15-month-old Cedar Rapids child — were both treated in May at UnityPoint Health-St. Luke’s Hospital in Cedar Rapids. Fortune spent nine days in the hospital starting May 13.

Now, several weeks after their hospital stays, both children are healthy, said Dr. Dilli Bhurtel, a pediatric cardiologist at St. Luke’s Hospital who was on the patients’ care team.

Health care providers were first alerted to this syndrome May 14 by the Centers for Disease Control and Prevention after doctors in the United Kingdom reported dozens of cases appearing in children between 4 and 6 weeks after they were sickened with COVID-19.

According to a national study conducted by CDC officials, there were at least 186 cases in 26 states by May. In New York, the hardest hit by the pandemic, the state health department reported that month at least three children with the syndrome died.

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Months later, public health officials and doctors don’t have a clear understanding of the long-term effects this syndrome can have on patients, Bhurtel said.

“What we do know about this disease is that it causes swelling of heart muscles,” Bhurtel said. “We know the patients recover well, but do they have any long term impacts? We don’t know.”

At home, Fortune’s dad, Kokou Djagni, said they still monitor his blood pressure and temperature, but since his recovery he’s been fine.

“He’s completely back to normal,” Djagni said.

Based on medical studies of Kawasaki disease in children, Bhurtel said the prospects for good health outcomes are high. However, doctors can’t be entirely sure, prompting Bhurtel and other providers at St. Luke’s to continue keeping a close eye on these patients.

Bhurtel said he has scheduled follow-up appointments up to a year after their hospitalization, but beyond that, it will be up to the parents and the primary care physician to keep an eye for any abnormalities.

“If anything new comes up, working with our primary care colleagues is the key,” Bhurtel said.

Fortune began exhibiting symptoms May 9, when he became lethargic and developed a low-grade fever. By the time he was admitted May 13 to St. Luke’s, he had low blood pressure and his heart wasn’t working as well as it should, Bhurtel said.

While they were never diagnosed, Djagni suspects his family would have been infected in mid-March. Nowadays, Djagni is not concerned about a another infection of the virus among members of his family.

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“I don’t have much concern about it anymore, that’s the way I’m feeling about it, he said. “We got it already, and our system is ready to fight it.”

Starting late last month, Iowa’s positivity rate reached 9.5 percent as the number of new cases statewide began to spike. As a result, in the first week of July, Iowa had the nation’s 11th worst rate of new cases per 100,000 people, according to a national analysis.

Most of the new cases in recent weeks are concentrated among individuals aged 18-25, but the surge has doctors like Bhurtel believing Iowa will see another case of multisystem inflammatory syndrome in young patients.

“We know that when the number of cases goes up, we’ll see cases between 4 to 6 weeks after,” Bhurtel said. “We’ve been keeping a constant watch out for that.”

Bhurtel said parents concerned their children may have this condition should contact their doctor immediately. However, he said while it’s important to be mindful of the possibility, parents should not panic because it remains rare.

Symptoms of multisystem inflammatory disorder in children and adolescents include:

• Persistent fever

• Conjunctivitis, or pink eye

• Rash

• Enlarged lymph nodes

• Swollen hands or feet

• Abdominal pain without explanation

• Vomiting and/or diarrhea.

Comments: (319) 398-8469; michaela.ramm@thegazette.com

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