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New York Gov. Andrew Cuomo (D) said Sunday that three New York children have died and 73 have become gravely ill with an inflammatory disease tied to COVID-19. The illness, pediatric multisystem inflammatory syndrome, has symptoms similar to toxic shock or Kawasaki disease. Two of the children who died were of elementary school age, the third was an adolescent, and they were from three separate counties and had no known underlying health issues, said New York health commissioner Dr. Howard Zucker. Cases have been reported in several other states.

New York City health officials warned about the disease last week, but health providers were alerted on May 1 after hearing of reports from Britain, The New York Times reports. Symptoms have included prolonged high fever, racing hearts, rash, and severe abdominal pain. Dr. David Reich, president of Mount Sinai Hospital in Manhattan, said the five cases his hospital treated started with gastrointestinal issues and progressed to very low blood pressure, expanded blood pressure, and in some cases, heart failure. “We were all thinking this is a disease that kills old people, not kids,” he told The Washington Post. Cuomo made a similar point.

It isn’t just children struggling with arterial inflammation. In fact, for a virus originally believed to primarily destroy the lungs, COVID-19 also “attacks the heart, weakening its muscles and disrupting its critical rhythm,” the Post reports. “It savages kidneys so badly some hospitals have run short of dialysis equipment. It crawls along the nervous system, destroying taste and smell and occasionally reaching the brain. It creates blood clots that can kill with sudden efficiency.”

Many scientists now believe coronavirus wreaks havoc in the body through some combination of an attack on blood vessels, possibly the endothelial cells that line the blood vessels, and “cytokine storms,” when the immune system goes haywire. “Our hypothesis is that covid-19 begins as a respiratory virus and kills as a cardiovascular virus,” Dr. Mandeep Mehra at Harvard Medical School tells the Post. Read more about the different ways COVID-19 attacks the body at The Washington Post.

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