Even though Covid-19 infections are steadily declining in India, the emergence of new variants coupled with the fear of a third wave, have kept everyone on their toes. Further, there are speculations that new strains of the virus might impact children more adversely than adults. Amid these uncertainties, a syndrome called MIS-C is on the rise in children, who have recovered from the virus and it is becoming a serious cause of concern around the globe.
Here’s all you need to know about it:
What is multisystem inflammatory syndrome in children (MIS-C)?
The multisystem inflammatory syndrome in children (MIS-C) is a severe disorder that appears to be associated with Covid-19. Most children who become infected with the virus only report minor sickness. But once affected by MIS-C, their health can get adversely affected. Some organs and tissues, including the heart, lungs, blood vessels, kidneys, digestive system, brain, skin, and eyes, become severely inflamed in children who acquire MIS-C. The signs and symptoms differ depending on which parts of the body are affected.
MIS-C is uncommon, and most children who have it improve with medical treatment. However, some children’s health swiftly deteriorates to the point where their lives are jeopardised.
What are the symptoms?
The symptoms of MIS-C can differ from child to child. Prolonged fever (lasting more than 24 hours and usually present for many days), red eyes, abdominal pain, vomiting, diarrhea and loss of appetite are the key symptoms of the syndrome. MIS-C symptoms can worsen quickly, so get medical assistance right away if you notice anything unusual in your child.
Emergency warning signs of MIS-C
• Severe stomach pain
• Difficulty breathing
• Pale, Gray or blue-colored skin, lips, or nail beds — depending on skin tone
• New confusion
• Inability to wake up or stay awake
Researchers from Imperial College London, UK, reported that the disorder is distinguished by a continuous high temperature, which is frequently accompanied by abdominal pain, vomiting, red eyes, and a red rash. According to the study, most global reports indicate a 2-4% death rate connected with the illness. Further, an important concern has been that some affected children have developed inflammation of their arteries that supply the heart with blood, resulting in widening of these arteries, they said.
What is the treatment?
According to a study, corticosteroids, a class of medications that reduce inflammation, may provide effective treatment for children who develop the illness.
The study "suggests that steroids may be a cheaper and more available alternative to immunoglobulin," said Elizabeth Whittaker, one of the authors of the study from Imperial College.
"Corticosteroids are cheap and available worldwide whereas immunoglobulin is expensive, and there is a worldwide shortage of it. This is a particular problem in many low- and middle-income countries," she added.
Two different types of treatments were initially carried out for the study-
• administration of a type of steroid called corticosteroids
• antibody treatment called immunoglobulin.
The study also compared initial treatment with steroids together with immunoglobulin.
Which is the best treatment available?
Hundreds of doctors from around the world participated in the study by submitting information about patient outcomes to an online database. All three therapies — immunoglobulin, immunoglobulin plus corticosteroids, and corticosteroids alone — resulted in a faster decrease in inflammation.
According to the researchers, there were no significant differences between the three therapies in the rate of recovery from organ failure or progression to organ failure. They stated that the number of deaths (2%) was too low to compare therapy, although death was part of a combined evaluation of organ failure that found none of the three treatments to be significantly different.
The study was then limited to the 80% of children who satisfied the World Health Organisation’s MIS-C criteria. When compared to immunoglobulin alone, those getting steroids alone as the first treatment had a lower rate of organ failure or death after two days. However, the authors emphasise that there is insufficient evidence to conclude that all three treatments are equally effective in preventing coronary artery aneurysms.
"Our finding, that treatments with immunoglobulin, steroids or a combination of both agents all result in more rapid resolution of inflammation will be of great value to pediatricians worldwide in their treatment of children with this new disorder," said Professor Michael Levin, from the Department of Infectious Disease at Imperial, who led the study.
“As immunoglobulin is unavailable or in short supply in many countries, and is expensive, the findings may provide some reassurance for those who only have access to corticosteroids," Levin added.
(With PTI inputs)