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COVID-19: Inflammatory Syndrome, Serology Surveillance

The Centers for Disease Control and Prevention (CDC) issued a health advisory of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19.

Clinicians in the United Kingdom on April 26 first reported MIS-C in previously healthy children who tested positive for SARS-CoV-2, the virus that causes COVID-19. These patients had symptoms similar to Kawasaki Disease, an inflammatory condition present most often in children, including a persistent fever, hypotension, multi-organ involvement, and elevated inflammatory markers.

The New York State Department of Health and Mental Hygiene on May 12 reported 102 patients with MIS-C, many of whom tested positive for COVID-19. Health care providers should report suspected cases  of MIS-C in patients younger than 21 to their local, state, or territorial health departments.

CDC Shares Serology Surveillance Strategy

The CDC on May 17 announced its strategy for using serology testing to survey how many SARS-CoV-2 infections have occurred and guide infection control measures.

Serology tests detect antibodies — proteins that fight off infections — in the blood. The presence of these antibodies, or seroprevalence, can indicate the total number of people infected, including asymptomatic carriers. CDC seeks to study infection trends over time, risk factors, and the length of time antibodies can be found after a COVID-19 infection, using three types of surveys.

Large-scale geographic seroprevalence surveys will target areas highly affected by COVID-19, including Washington and New York states. These studies will include blood samples originally used for other purposes, such as cholesterol tests. CDC also will partner with state and county health departments to sample county-specific data. Finally, CDC will study seroprevalence in special populations, such as health care workers and pregnant people, to assess infection risk in these populations.

CDC Framework for Delivering Care Unrelated to COVID-19

As health care facilities resume care for urgent and emergent health needs unrelated to COVID-19, CDC urges providers to:

  • prepare to detect and respond to an increase in COVID-19 cases;
  • optimize telehealth services when possible and follow infection control practices to keep patients safe; and
  • gradually expand services, prioritizing services most likely to cause patient harm if deferred and at-risk populations that would benefit most from resuming services.

The framework weighs the risk of community transmission with the potential for patient harm if the procedure is deferred, including a list of example procedures for each level of harm potential. For additional information, America’s Essential Hospitals’ May 7 webinar, Guidance on Resuming Hospital Procedures, is available on-demand. This webinar featured association member University of Chicago Medicine’s Medically Necessary Time-Sensitive (MeNTS) prioritization process.

CDC also released a report outlining initiatives to correspond with President Trump’s Guidelines for Opening Up America Again, including criteria for entering each of the three phases of reopening, efforts to improve contact tracing, and technical support for states.

Visit the America’s Essential Hospitals coronavirus resource page for more information about the outbreak.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Emily Schweich is a communications manager at America's Essential Hospitals.

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