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COVID-19: Multisystem Inflammatory Syndrome In Children (MIS-C) Of Covid-Recovered Families

Recent reports show that many children in COVID-recovered families in Maharashtra, are showing symptoms of a multisystem inflammatory syndrome in children (MIS-C). The first case of this nature was reported by the Times of India, where it pointed out that in Nagpur as many as six such patients, between the ages of 2-12, were admitted to the hospital after showing signs of MIS-C.

The doctors from the hospital in Nagpur said, "children in families that have tested positive for the coronavirus might have built 'Covid antibodies,' leading to MIS-C" [1].

Previously, in July 2020, a report from a hospital in Mumbai stated that children who have been admitted with the COVID-19 infection are developing a life-threatening syndrome called pediatric multisystem inflammatory syndrome (PMIS) or multisystem inflammatory syndrome in children (MIS-C).

The report says that out of the 100 children have been treated for the coronavirus infection, 18 have been diagnosed with the paediatric multisystem inflammatory syndrome (PMIS), and tragically, one of the children has died [1].

Other cases of PMIS has been reported around the world, with the doctors warning the parents to look out for symptoms of this rare syndrome in their kids. The Centers for Disease Control and Prevention (CDC) have confirmed that more than 150 reported cases of PMIS are linked to COVID-19 [2].

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Though data around the globe suggests that children and teenagers are comparatively safe from the coronavirus infection, as they tend not to become severely ill. However, the recent reports raise caution as a significant per cent of children with Covid-19 are developing PMIS.


What Is Multisystem Inflammatory Syndrome (MIS-C), How Is It Linked To COVID-19?

PMIS, also known as multisystem inflammatory syndrome in children, or MIS-C affects organs and blood vessels [3]. PMIS develops when the blood vessels become inflamed, but the cause behind the condition is not known.

The immune system may cause severe inflammation in some children who are more likely to develop PMIS, based on their genetics. The disease is not contagious, and the symptoms are similar to Kawasaki disease, which also had been linked to COVID-19 [4].

Doctors have asserted that there is a direct link between MIS-C and COVID-19 in terms of timing and geographical association. However, as it is an evolving situation, extensive monitoring of the disease is being carried out.

While COVID-19 is a respiratory disease, MIS-C affects the organs and blood vessels, especially the ones around the heart and if left untreated, can cause tissue damage, organ failure and even death [5].

The doctors further pointed out that a child, after being exposed to the coronavirus, the symptoms of PMIS develop in some after three to four weeks. The temporal relation between the two disorders, that is, the hypothesised relationship in terms of the time of onset is clear.


What Are The Symptoms Of Multisystem Inflammatory Syndrome (MIS-C)?

The common symptoms of MIS-C are as follows [6]:

  • Severe abdominal pain, vomiting or diarrhoea
  • Bloodshot eyes
  • Skin rash
  • Fever that lasts more than five days and gets higher
  • Redness or cracking in the lips or tongue
  • change in skin colour (pale, patchy or blue)
  • Difficulty feeding
  • Trouble breathing
  • Swollen lymph nodes in the neck
  • Chest pain
  • Racing heart
  • Confusion, irritability or lethargy
  • Swelling and redness in the hands and feet
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How Is Multisystem Inflammatory Syndrome (MIS-C) Diagnosed?

For the diagnosis purpose, doctors will collect a detailed history of the child, do a physical exam and blood tests. To get a clearer understanding, an echocardiogram (ultrasound) of the heart may be carried out [7].


How Is Multisystem Inflammatory Syndrome In Children (MIS-C) Treated?

Doctors are learning about the spectrum of illness and symptoms in PMIS associated with COVID-19. Mild symptoms such as fever, cough or sore throat, can be treated at home with fluids and fever medication [8].

Children with severe MIS-C should be hospitalised and may be treated with medications to help manage the blood pressure levels, heart function, or to treat blood clots. If the child has MIS-C and COVID-19, they may also need blood products and antiviral therapy [9]. Also, different types of corticosteroids or anti-inflammatory medications are used in the treatment.


On A Final Note…

Currently, such cases have been reported from Nagpur, Yavatmal, Washim and Buldhana, but parents who have recently recovered from COVID-19 have been advised to keep an eye for the onset of symptoms in their children.

Previously, the doctors had ensured that timely treatment could help manage and control the inflammatory syndrome. The majority of patients, even the sickest ones, had recovered.


Frequently Asked Questions

Q. Is PMIS contagious?

A: No. According to current understanding, PMIS seems to be a post-infectious complication of COVID-19. It develops after several weeks after initial infection and is therefore not contagious.

Q. What causes PMIS?

A: The cause of PMIS is not known, but doctors think it is related to a COVID-19 infection.

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