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June 18, 2020

How a seemingly 'perfectly healthy' teenager died from Covid-19

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    Dawn Guest says her son, Andre, seemed like "a perfectly healthy 16-year-old boy," but after feeling tired and falling in his bathroom, Andre ended up in the hospital—and 12 days later, he died from Covid-19, Tarena Lofton reports for Kaiser Health News.

    Children may not be immune from deadly Covid-19 complications, doctors warn

    Slurred speech, lost grip, and confusion

    Since Dawn works as a nurse in a nursing home, the entire Guest household was taking extra precautions to protect themselves against the new coronavirus, Lofton reports. 

    After every shift, Dawn would take her shoes off at the door before entering her home, and she'd go straight upstairs to shower while her husband disinfected her belongings. The family regularly disinfected surfaces in the house, wore masks when outside of their home, and practiced social distancing as much as they could. And Andre hadn't left the house at all, Lofton reports.

    But one morning, Andre asked his dad, Johnny, for help getting a drink, which Dawn found to be odd. By 1:30 p.m. that day, Johnny went to check on Andre, who said he was tired, Lofton reports. Johnny noticed that Andre's "speech was really slurred," though "[h]e could still understand … and answer," according to Johnny. Shortly after, Andre fell in the bathroom, and Johnny called Dawn to tell her something was wrong.

    When Dawn got home, Andre couldn't grip objects, had difficulty standing up, couldn't hold up his body weight, seemed confused, and his head and eyes were rolling, Lofton reports. Dawn called an ambulance, which took Andre to a nearby ED. The ED transferred Andre to Riley Hospital for Children.

    Andre's condition worsens—but he initially tests negative for the new coronavirus

    Andre had no known underlying medical conditions, but doctors at Riley discovered that Andre had developed Type 1 diabetes and that his blood sugar was at 1,500 milligrams per deciliter—a measurement 10 times the normal amount, Lofton reports. 

    Since Andre had a fever and was coughing, providers also ordered a test to determine whether Andre was infected with the new coronavirus. That test came back negative, Lofton reports.

    Meanwhile, doctors had difficulty controlling Andre's blood sugar, which is abnormal, Lofton reports. According to Lofton, getting a patient's blood sugar under control typically is "fairly straightforward with an insulin infusion in a first episode of diabetes."

    A positive test, and a possible case of rare inflammatory syndrome tied to coronavirus

    In addition, Andre's temperature kept spiking and his breathing continued to get worse, even though he was receiving oxygen supplements. Doctors again tested Andre for the new coronavirus, and this time, the results came back positive. They then transferred Andre to a unit for patients with Covid-19, the disease caused by the virus. 

    Andre was in the hospital for a period of 12 days, and during that time, he developed problems with a number of his organs, including his brain, heart, lungs, and kidneys. As Andre's condition continued to worsen, doctors tried a variety of treatments, including placing Andre on a ventilator and proning—a treatment in which providers place a patient on their stomach to improve their lung capacity. Doctors were unable to give Andre remdesivir, an experimental treatment for Covid-19, because his kidney and liver function were too poor, Lofton reports.

    "Everything that they would fight to try to correct, the coronavirus would find something else to attack," Johnny said.

    Eventually, Andre's blood sugar came back down to normal levels. But on the morning of April 27, his blood sugar spiked again and his arterial lining started to clot, which suggested that Andre was experiencing coagulation issues—a common phenomenon in Covid-19 patients, Lofton reports. Andre went into cardiac arrest and, despite doctors performing chest compressions, died.

    According to Lofton, many of the symptoms Andre experienced were similar to those seen in other children who have developed a multisystem inflammatory syndrome that providers and researchers believed is tied to the new coronavirus, but his providers did not diagnose him with the condition.

    'You have no idea if you're a carrier'

    Dawn said "every nurse and every doctor" who cared for Andre was "wonderful." 

    "I can't complain," she said. "We just didn't get the results that we wanted."

    But Dawn cautioned that people must be careful to take precautions that could prevent them from contracting the new coronavirus—and spreading it to others.

    "You are taking care of your community, as much as you're taking care of yourself," Dawn said. "You have no idea if you're a carrier or if you've touched something that has [the new coronavirus] on there."

    Andre's father and two sisters also tested positive for the new coronavirus and developed mild cases of Covid-19, experiencing minor fevers and fatigue. Dawn at the time had elected not to be tested, because she was at the hospital with Andre and knew that, if she tested positive for the virus, she wouldn't have been able to stay with him, Lofton reports (Lofton, Kaiser Health News, 6/15).

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