What is MIS-C, and how is it affecting children during the pandemic?

More than 250 kids in the United States have multisystem inflammatory syndrome in children, also called MIS-C, according to Newsweek.  Although health experts initially believed that kids were not at high risk of suffering from COVID-19, now they think this new syndrome is connected to the coronavirus.

The kids who developed MIS-C either had COVID-19 or had been around someone with it, the Centers for Disease Control and Prevention says

While COVID-19 has primarily impacted the lungs in those who are infected, children with MIS-C could have an inflammation of the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. 

The CDC says typical symptoms of MIS-C include: 

  • Fever
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Neck pain
  • Rash
  • Bloodshot eyes
  • Feeling extra tired

Parents should seek emergency care if their kids have these emergency warning signs of MIS-C: 

  • Trouble breathing
  • Pain or pressure in the chest that does not go away
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
  • Severe abdominal pain

Clinicians initially identified MIS-C on April 26 in the United Kingdom. Originally, they believed it was Kawasaki disease, an acute febrile disease that primarily affects children and shares similar symptoms like fever, rash, and bloodshot eyes. But doctors say MIS-C differs from Kawasaki disease because infected kids have so far consistently had COVID-19 antibodies. 

Now, more than 20 states report at least one MIS-C case, and three kids have died from the syndrome. The disease, though, seems to be rare and that most patients recover. Newsweek reports that New York state has identified the majority of MIS-C cases in the U.S., with 157 cases. Washington D.C. has the second-highest number, with 23 kids hospitalized. New Jersey reports 17 cases, while Georgia reports 15.

Doctors say they’ve seen a rapid increase in diagnoses. Charles Berul, co-director of the Children’s National Heart Institute, told Politico in late May that his hospital in Washington D.C. had treated about 30 children with the syndrome in the past two weeks. 

“This seems like all of a sudden,” said Berul. “It’s rare, but just 30 in two weeks could be a lot of children in the end.”

Doctors identify MIS-C through a series of tests, including blood tests, chest X-rays, and heart and abdominal ultrasounds. The CDC says most children who contract MIS-C will be hospitalized, and some will need to be treated in the pediatric intensive care unit (PICU). The kids are treated with “high doses of aspirin and immunoglobulin to suppress the inflammation,” according to Politico. 

Dr. Roberta DeBiasi, the chief of pediatric infectious diseases at Children’s National, told NPR that doctors treat MIS-C with immunoglobulin (an infusion of antibodies found in the blood from outside donors) to prevent injury to the coronary artery. Damage to the artery can lead to myocardial ischemia and heart attacks later in life. 

Because this latest discovery indicates that the development of coronavirus antibodies makes children more susceptible to MIS-C, doctors worry children could be at risk if they are administered a COVID-19 vaccine (which would then cause those antibodies), NPR says. This brings into question whether it will be safe to vaccinate kids for COVID-19 when a vaccine is developed. 

The CDC says the best way to protect children from MIS-C is to take precautions that prevent COVID-19, including social distancing and frequent hand washing. 

“It is important to remember that overall, children fare very well with COVID-19 as compared to adults,” Boston Children’s Hospital wrote. “Only a small number of children seem to develop signs and symptoms of MIS-C, and most have recovered quickly.”

As of July 15, the CDC has received reports of 342 children who have been infected with MIS-C with six of those children dying.

Sources: Newsweek, CDC, Politico, NPR, Boston Children’s Hospital

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