Well, lets get rid of some of the 'assumptions' you've been suggesting, for a start.
CDC published COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United States, March–July 2020 in
Morbidity and Mortality Weekly Report on Aug. 14 last, and laid out some facts. Link to the article & tables:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6932e2.htmand here are a few relevant extracts:
- As of July 29, 2020, a total of 570 MIS-C patients with onset dates from March 2 to July 18, 2020, had been reported from 40 state health departments, the District of Columbia, and New York City;
- A total of 203 (35.6%) of those patients had a clinical course consistent with previously published MIS-C reports, characterized predominantly by shock, cardiac dysfunction, abdominal pain, and markedly elevated inflammatory markers, and almost all had positive SARS-CoV-2 test results. The remaining 367 (64.4%) of MIS-C patients had manifestations that appeared to overlap with acute COVID-19 (2–4), had a less severe clinical course, or had features of Kawasaki disease;
- Latent class analysis identified three classes of patients, each of which had significantly different illness manifestations related to some of the key indicator variables. Class 1 represented 203 (35.6%) patients who had the highest number of involved organ systems. Within this group, 99 (48.8%) had involvement of six or more organ systems; those most commonly affected were cardiovascular (100.0%) and gastrointestinal (97.5%). Compared with the other classes, patients in class 1 had significantly higher prevalences of abdominal pain, shock, myocarditis, lymphopenia, markedly elevated C-reactive protein (produced in the liver in response to inflammation), ferritin (an acute-phase reactant), troponin (a protein whose presence in the blood indicates possible cardiac damage), brain natriuretic peptide (BNP), or proBNP (indicative of heart failure) (p<0.01) . Almost all class 1 patients (98.0%) had positive SARS-CoV-2 serology test results with or without positive SARS-CoV-2 RT-PCR test results. These cases closely resembled MIS-C without overlap with acute COVID-19 or Kawasaki disease.
- Within the Class 1 group, reported serum laboratory values showed (presumably on hospitalisation) among other values e.g. platelets, ferritin:
- BNP, peak (pg/mL) 53 patients, median value of 1,321, IQR of (414–2,528)
- CRP, peak (mg/L) 166 patients, median value of 21, IQR of (14–29)
So, as
@eieio said, the two children referred to in the
Pediatrics article were clearly severe cases (outliers) - with BNP's of 4465 and 6528, and CRPs of 147 and 231 respectively, post SOC and MIS-C treatment and immediately prior to Remestemcel-l treatment. There seems no doubt that the progression of their disease was unacceptable to clinical staff, and far outside the norm for MIS-C patients. To suggest that any conclusion should be drawn simply from the fully-disclosed involvement of MSB consultants in the therapy is disingenuous, to say the least.
(20min delay)