Q: My nephew went to the hospital for a cough, and was admitted for something called MIS-C. What is MIS-C?
A: Thank you for your question. MIS-C stands for multisystem inflammatory syndrome in children. MIS-C is a rare complication associated with COVID-19.
Most children have fever, gastrointestinal symptoms and possibly a rash. Others develop inflammation of the blood vessels, which can include the blood vessels that supply the heart, called coronary arteries.
The most serious complication of MIS-C is inflammation of the coronaries which leads to decreased heart function and increased risk of heart attacks or heart failure, even in small children.
This is the first time we have seen an illness which is contagious, spreading quickly and can cause serious heart damage in children.
In the past, we knew that children born with congenital heart disease who required surgical repair were at increased risk for heart conditions. There is also a well-known pediatric condition called Kawasaki’s disease which occurs in small children and can cause heart problems.
Kawasaki’s is an inflammatory response to a viral illness, just as MIS-C is an inflammatory response to the Covid-19 virus, so many of the signs overlap.
The way these conditions cause illness, the way they affect organs particularly the heart, seems to be the same. The thing that makes kids sick is the way their body’s immune system responds to the viral infection, not the virus itself.
The sort of immune response that the virus triggers in the body is a bigger problem than the actual effects of the virus itself. Due to the similarities between Kawasaki’s and MIS-C, the treatments are the same for both conditions.
Currently treatment includes hospitalization, an infusion of a medication called intravenous immunoglobulin and high-dose aspirin therapy until fever resolves. Then the child continues lower dose aspirin therapy for a few weeks.
They will most likely have one follow-up visit with a cardiologist to make sure the heart recovered well. There are other additional therapies like intravenous steroids and “biologic agents” called monoclonal antibodies that some hospitals use. The goal of these additional medications is to further quiet the immune system and decrease the inflammation which injures blood vessels.
The signs of MIS-C include: fever higher than 101 degrees Fahrenheit; abdominal pain; vomiting; diarrhea; high heart rate; low heart rate or irregular heart rate; skin rash; red cracked lips; conjunctivitis; swollen lymph nodes in the neck; swelling of the hands and feet; cough or difficulty breathing; and any sort of unusual headache or altered mental status.
A child may not have all the symptoms.
A child’s Covid PCR, the nasopharyngeal swab which diagnoses acute infection, will usually be positive. Occasionally, the PCR swab is negative but the child’s Covid antibodies (a blood test) will be positive. It is a combination of having Covid infection and having signs of whole body inflammation which leads to the diagnosis of MIS-C.
The latest numbers show that 1.4 million American children aged 1-to-18 years have been diagnosed with Covid-19 infection. That amounts to 12% of all Covid cases.
In other words, 1 in 9 patients who contracts Covid-19 is a child. And 900 cases of MIS-C have been reported, with 16 deaths.
While it appears that kids tend to get less sick than adults with Covid-19, some kids get very sick indeed, and MIS-C is one of the more difficult consequences of Covid for kids.
Fortunately, with treatment most kids do very well.
After reading all this you may be asking yourself, “What should I do if a child I know might have MIS-C?” You can please advise that the child be seen by a pediatrician, and be tested for Covid-19 and for Covid antibodies. If the child is diagnosed with MIS-C, it is advisable that they are admitted to a hospital which has a pediatric intensive care unit and has pediatric cardiologists and pediatric infectious disease doctors available to participate in their care.
We are currently tracking and reporting all cases of MIS-C in order to learn more about the condition and more quickly access newer, better treatment plans.
The next logical question is “Would giving kids the Covid vaccine help prevent MIS-C?” It seems reasonable to assume that it would.
However, we are a ways off from kids even getting the vaccine. None of the companies making the vaccines have tested any on children. Moderna announced that it will soon start testing on kids aged 12-to-17 years. You can find more information on this at NPR, npr.org/sections/coronavirus-live-updates/2020/11/27/939341531/a-covid-19-vaccine-for-children-may-still-be-many-months-away.
Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Please send your questions to asubbaswamy@salud.unm.edu.
"condition" - Google News
December 15, 2020 at 02:02PM
https://ift.tt/3agtUMa
MIS-C is serious inflammatory condition in kids - Albuquerque Journal
"condition" - Google News
https://ift.tt/2W6ON50
https://ift.tt/2L1ho5r
Bagikan Berita Ini
0 Response to "MIS-C is serious inflammatory condition in kids - Albuquerque Journal"
Post a Comment