Disruptions to health care and lack of food from COVID-19 are likely to cost the lives of at least 250,000 babies and young children and more than 10,000 mothers in low- and moderate-income countries over the next six months, according to a study from researchers at Johns Hopkins University.

The study, published in The Lancet Global Health, modeled how many extra deaths could be expected from COVID-19’s impact on the food supply and medical systems in these countries. The study found a dramatic increase in maternal deaths from the absence of childbirth interventions like antibiotics and clean birth environments. Children will be more likely to die from lack of nutrition, reduced availability of antibiotics for pneumonia, sepsis and rehydration solution for diarrhea, according to the study.

In the worst-case scenario, nearly 1.2 million additional babies and about 57,000 mothers would die across the 118 countries in six months, the research found.

“If routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating,” the study concluded. “We hope these numbers add context as policy makers establish guidelines and allocate resources in the days and months to come.”

Most US kids with multisystem inflammatory syndrome had been healthy

A separate study found 3 in 4 children who come down with extremely serious cases of COVID-19 had no known health conditions that might raise their risk, according to a new study in the New England Journal of Medicine.

The national study, and another that looked at children hospitalized in New York state with the virus, confirmed that – very rarely – children can have a dramatic and dangerous reaction called multisystem inflammatory syndrome in children (MIS-C), likely caused by an immune reaction to the infection.

In the national study, nearly all the children with the condition had digestive problems, 80% had heart issues and nearly as many had problems with their blood. The children were hospitalized for about a week, with 80% treated in intensive care. Four of the 171 patients died.

The syndrome generally takes hold two to four weeks after infection with SARS-CoV-2, the virus that causes COVID-19, the studies found. The disorder is rare, occurring in just 2 out of 100,000 children, compared to 322 out of 100,000 who contract COVID-19, and it appears to be more common among Black, Hispanic, or South Asian children, according to an editorial that accompanied the studies.

The New York-specific study examined 99 children with suspected or confirmed cases of COVID-19. Just over half the patients were male, 40% were Black and 36% were Hispanic. Just under one-third were 5 years old or younger, 42% were ages 6-12 and 26% were 13-20.

All had fevers or chills and rapid heartbeats. About 60% had rashes and nearly as many had eye redness, which can often indicate inflammation. Two of the New York patients died.

“There is concern that children meeting current diagnostic criteria for MIS-C are the ‘tip of the iceberg,’ and a bigger problem may be lurking below the waterline,” Dr. Michael Levin, chair in pediatrics and International Child Health at Imperial College London, wrote in the editorial, adding that the syndrome presents significant challenges for doctors trying to treat these dangerously sick children.

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