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Some patients at a California children’s hospital have developed a rare inflammatory condition possibly linked to the novel coronavirus. The condition has also been reported in recent weeks in pediatric coronavirus cases in New York and the United Kingdom.

At least three patients at Children’s Hospital Los Angeles displayed signs of the pediatric inflammatory multisystem syndrome, or PIMS, which doctors have said is similar to Kawasaki disease, or a condition that causes swelling in medium-sized arteries throughout the body. Kawasaki disease, which primarily affects children and has less than 6,000 diagnosed cases in the U.S. each year, often leads to inflammation in the coronary arteries, according to the Mayo Clinic.

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Testing later revealed that the patients who displayed symptoms of PIMS — said to include high fever, swollen hands and feet, red, cracked lips, and a red tongue and eyes, not unlike signs of Kawasaki disease — had antibodies against the novel coronavirus, hinting at a possible link between the two, Dr. Jacqueline Szmuszkovicz, a pediatric cardiologist at Children’s Hospital Los Angeles, told The Los Angeles Times. 

“The fact their antibodies came back positive means this inflammation may be a response to a COVID-19 infection in the past,” Szmuszkovicz told the news outlet.

Doctors at Children’s Hospital Los Angeles are now reconnecting with patients who were diagnosed with Kawasaki disease at the start of the pandemic to test them for antibodies against the novel virus, Szmuszkovicz added.

The news comes after British health authorities in a warning to health care professionals in late April said that some severely ill pediatric patients in the country — including some who were positive for the coronavirus — presented an “unusual clinical picture” that included inflammatory symptoms possibly linked to COVID-19.

The U.K. Pediatric Intensive Care Society (PICS), citing an email alert from the National Health Service (NHS) in England, said in a news release that health officials had reported “a small rise in the number of cases of critically ill children presenting with an unusual clinical picture” at the time. More specifically, it is a “multi-system inflammatory state” that may be connected to the novel virus.

“The cases have in common overlapping features of toxic shock syndrome and atypical Kawasaki disease with blood parameters consistent with severe COVID-19 in children. Abdominal pain and gastrointestinal symptoms have been a common feature as has cardiac inflammation,” the NHS notice reads, per PICS.

A similar condition also affected at least three children in New York who tested positive for the novel virus, as well as at least one child in Louisiana.

A 6-month-old who was hospitalized in California with Kawasaki disease last month also tested positive for COVID-19, Reuters reported at the time.

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Szmuszkovicz told The Los Angeles Times that children who have a fever that lasts for four or more days should seek medical attention.

“Certainly, if they see any of the other signs — the rash, the red tongue, red eyes — we encourage them to seek care,” she added.