As the second wave of the pandemic ebbs in India, it appears that COVID-19 has been kinder to children (individuals below the age of 18 years) as compared to adults across both waves. The number of children infected has been far less than the number of adults, and most infected children are asymptomatic or mildly symptomatic.
However, a small proportion of symptomatic children may develop more serious COVID-19 symptoms and require hospitalisation.
In a few cases, children may exhibit severe symptoms several weeks after being infected with the novel Coronavirus and develop a condition called multisystem inflammatory syndrome in children (MIS-C).
The number of cases of MIS-C being reported in children has increased during the second wave of the pandemic.
But what is MIS-C? Let’s find the answers to the most common questions about it.
1. What is MIS-C?
Multisystem inflammatory syndrome in children or MIS-C is a condition in children in which there is a persistent fever along with inflammation in different body parts including the heart, lungs, kidneys, brain, skin, eyes, food pipe, liver, gallbladder, pancreas, stomach, and intestines.
Inflammation is the excessive and exaggerated reaction of the immune system to ward off a foreign agent, which causes redness, swelling, pain, production of heat, and loss of function.
In MIS-C, the inflamed organs, especially the heart, can get damaged.
2. What is the connection between MIS-C and COVID-19 in children?
Researchers are still trying to find out what causes MIS-C and how it is related to COVID-19. However, MIS-C is believed to be an inflammatory reaction in a child’s body about 2 to 6 weeks after a COVID-19 infection.
Some experts believe that MIS-C may be due to a reaction in a child’s body to the antibodies (proteins produced by the immune system to fight against foreign agents) produced against the coronavirus during a COVID-19 infection.
3. What are the most common symptoms of MIS-C?
You should contact a doctor immediately if your child has one or more of the following symptoms:
A persistent fever of 100.4 °F or more
Weakness or dizziness
Red eyes
Rashes all over the body
Red, cracked lips
Neck pain
Abdominal pain
Diarrhoea
Vomiting
Sleepiness or confusion
Swollen hands and feet
4. How is MIS-C diagnosed?
The diagnosis of MIS-C is based on observation of presenting symptoms and laboratory tests to look for signs of inflammation. The tests include:
COVID-19 test (RT-PCR test)
Lab tests such as blood and urine tests
Imaging tests such as chest X-ray, CT (computed tomography) scan, and echocardiogram (heart ultrasound)
ECG (electrocardiogram)
An interdisciplinary approach involving paediatric specialists in intensive care, cardiology, rheumatology, haematology, and infectious disease may play an important role in the treatment of MIS-C.
5. Is MIS-C treatable?
Yes, MIS-C is a treatable condition and most children recover fully with medical care. The condition has a good outcome if it is diagnosed early.
Children with MIS-C will need to be treated in the hospital and some cases may need care and attention in the ICU (intensive care unit).
Doctors treat MIS-C by:
Supportive care: Intravenous fluids, oxygen, and medications are administered to reduce and prevent excessive blood clotting.
Treating inflammation and swelling: Antibiotics, steroid therapy, immunoglobulins, and other therapies are given to combat inflammation.
MIS-C can have serious effects in children, but it is very rare. Timely diagnosis and treatment is the key to a successful resolution of the syndrome in most cases. Do not panic, and watch out for any unusual symptoms in children at home.
Although research is still being carried out on MIS-C, the best way to prevent MIS-C is to prevent COVID-19 in children.
Continue to follow COVID-19 appropriate behaviour, get vaccinated, and get your children vaccinated when a vaccine is available.
References:
1. Mohfw.gov.in. 2021. [online] Available at: <https://www.mohfw.gov.in/pdf/GuidelinesforManagementofCOVID19inCHILDREN18June2021final.pdf> [Accessed 15 September 2021].
2. Who.int. 2021. Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19. [online] Available at: <https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19> [Accessed 15 September 2021].
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