A sharp spike in MIS- C among children is concerning. As we continue to ramp up efforts to bend the Covid curve, the rising number of MIS-C (Multi-Organ Inflammatory Syndrome in Children) is keeping doctors busy and parents worried. We are witnessing children mostly between 1 to 18 years along with rare cases in babies who are six months old being admitted to hospitals with post-Covid MIS-C. Over 200 cases of this syndrome in children have been treated in various NCR hospitals alone over the last 2 weeks. This alarming challenge now seeks collaborative efforts to find out a way ahead.
MIS-C is a serious condition that is associated with Covid infection. Children who get infected with Covid have mild symptoms in the majority of cases but a small portion of them may develop MIS-C 3-6 weeks later and may need hospitalisation. As the name suggests there is inflammation leading to organ dysfunction and if not treated in time, may lead to mortality in rare instances. A clear understanding of its pathogenesis is not yet there but it is presumed to be antibody-mediated where the body’s immune system reacts against these antibodies and leads to a hyperimmune reaction causing damage to various organs. Organs most commonly affected are the heart and cardiovascular system, GI tract, skin, eyes, brain, and kidneys. A condition similar to this is now also being reported in young adults (20 to 35 years) and it is being referred to as MIS-A (a multi-system inflammatory syndrome in adults).
The signs and symptoms of MIS-C in children include a fever that lasts for more than 24 hours, stomach pain, rashes on the skin, unusual tiredness, fast heartbeat, redness of eyes, redness or swelling of the lips and tongue, redness or swelling of the hands or feet headache, dizziness, among others. If not detected early, the disease may progress to organ failure in some cases and the child may present in critical condition. To diagnose MIS-C, doctors may do certain tests to look for inflammation or other evidence of disease. These tests include blood tests, chest x-ray, echocardiography of the heart among others. Once MIS-C is diagnosed, Doctors can use medicines such as intravenous immunoglobulin, steroids, and other anti-inflammatory drugs to reduce the inflammation and protect the heart, kidneys, and other organs from lasting damage. Most children who develop symptoms of organ dysfunction will have to be treated in the hospital. In severe cases, patients may require admission to pediatric intensive care units (ICU).
Fortunately, most children who have it rapidly get better with adequate medical care. But some kids may get worse, to the point where their lives are at risk. Many children with MIS-C have a positive antibody test result. This means they've had exposure to the Covid-19 virus in the recent past. Since only a small number of children develop MIS-C, there may be genetic factors that make some children susceptible. Although the exact reason behind the occurrence of the syndrome in children is not known yet, some experts believe that this could be due to an excessive immune response related to Covid-19.
It is known that symptoms of MIS-C occur after Covid infection and the best way to prevent MIS-C is to keep taking steps to help avoid exposure to coronavirus through Covid-appropriate behaviors. MIS-C may sound scary but the condition is very rare. Proper care, early detection, and timely treatment can help defeat the condition.
(Dr. Prabhat Maheshwari, Chief- Neonatal & Paediatric Critical Care, Artemis Hospitals)