Exposure to COVID-19 can cause rare but potentially fatal pediatric disease

Exposure to SARS-Co-V2, the virus that causes COVID-19, may put healthy children and adolescents at risk for multisystem inflammatory syndrome in children (MIS-C), a rare but pediatric disease. potentially fatal that can cause severe inflammation of organs such as the heart, brain, lungs, kidneys and gastrointestinal system.

Diagnose and treat MIS-C – which has affected 2,600 children since May 2020 and is known to occur in children who have tested positive for SARS-Co-V2 or who have been exposed to someone with COVID-19 – is difficult because respiratory and gastrointestinal symptoms can be similar to those of severe COVID-19. Other features of MIS-C are very similar to Kawasaki disease, which causes inflammation of the blood vessels.

Steven Horwitz, assistant professor of pediatrics at Rutgers Robert Wood Johnson Medical School, and author of a study recently published in The Journal of the American Medical Association, examined 1,116 people under the age of 21 hospitalized from March to October 2020 with symptoms that could have been caused by one of these disorders and compared their clinical and laboratory results to determine how to more accurately diagnose MIS-C .

What is MIS-C and why is it difficult to diagnose?

MIS-C is a new phenomenon in pediatrics. It occurs in association with SARS-CoV-2 infection, but symptoms can be delayed for several weeks in children who have COVID-19, the illness resulting from the virus, but who are asymptomatic.

To complicate the diagnosis, the symptoms of MIS-C are also similar to those of Kawasaki disease, the leading cause of acquired heart disease in children.

Although the symptoms are similar, the complications, treatments, and potential results may be different. If we can better distinguish these conditions, it will improve treatment and follow-up care.

How is MIS-C similar to and different from severe illness from COVID-19 and Kawasaki?

In general, children with MIS-C tend to become sicker than those with acute COVID-19 because more organs are involved. While children with acute COVID-19 may present with respiratory and gastrointestinal symptoms directly related to the virus, MIS-C appears to be an inflammatory response to infection that occurs several weeks later that may resemble COVID- 19.

In our study, 80% of children with MIS-C and COVID-19 each had severe respiratory symptoms, but more children with MIS-C had multiple organ damage, including heart problems and mucous membrane conditions, such as rash or redness in the eyes. resulting in a similar presentation in patients with Kawasaki disease.

Compared to COVID-19 and Kawasaki disease, MIS-C is more likely to affect Hispanic / Latino or black children; more likely to affect children who do not have underlying conditions; and more likely to affect people aged 6 to 12. It is more likely to cause gastrointestinal symptoms than Kawasaki disease.

Kawasaki disease and MIS-C affect boys more, but Kawasaki disease mainly affects those of Asian origin and appears in young children, between 2 and 3 years old.

How will this study inform treatment?

What we have learned will help refine how MIS-C is diagnosed and treated. For example, while children with COVID-19 or MIS-C might benefit from anti-inflammatory treatments such as steroids, children with MIS-C might also benefit from other treatment options such as immunoglobulin. intravenous.

These patients should also see a cardiologist to check for changes in heart function, cardiac arrhythmias, or coronary heart disease.

What Should Parents Know?

I have children, so I understand how nervous parents are about this new syndrome. If your child develops a multitude of symptoms such as persistent fevers, rashes, or seems unusually tired, have your child evaluated by a healthcare professional to rule out MIS-C.

Although MIS-C is a serious illness, most children, including those with severe heart symptoms, usually recover within 30 days.