Post-COVID-19: Multisystem Inflammatory Syndrome in Children (MIS-C)

Post-COVID-19: Multisystem Inflammatory Syndrome in Children (MIS-C)

According to the Multisystem Inflammatory Syndrome Covid-19 (MIS-C) Malaysian Study Group found that a total of 174 cases were identified. Furthermore, about 57% of the total cases are among children aged 5-11 years between June 2020 and December 2021.

Consequently, a large number require critical care in the pediatric intensive care unit (PICU). In addition, seven cases have been confirmed as dead.

What is a multisystem inflammatory syndrome in children (MIS-C)?

Multisystem inflammatory syndrome (MIS-C), in other words known as a pediatric multisystem inflammatory syndrome because it usually happens in children than older people.

This syndrome is actually a post-infectious complication of covid-19. Thus, we can see the syndrome develop after several weeks when kids get infected with the virus.

Besides that, Sick-Samuels says that MIS-C have signs and symptoms similar to toxic shock syndrome called Kawasaki disease, which both cause inflammation throughout the body such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

Moreover, the symptoms can be milder or very serious. As a result, require urgent medical care.

Symptoms of MIS-C?

A fever (exceed more than four days)
Red eyes
Rash
Vomiting and diarrhea
Cracked lips
Enlarged lymph node
Swollen hands or feet
Neck pain
Cough and shortness of breath
Dizziness and fatigue
Loss of odor and taste
Fast heartbeat

Above all, if he is experiencing any of this symptoms and getting even worse. Very bad belly pain, looking bluish on the lips or face, confusion, or inability to wake or stay awake for instance. Then, immediately take them to the nearest emergency department or call 911 or your local emergency number.

Diagnosis

As stated before, the symptoms of MIS-C are similar like Kawasaki disease. So, to differentiate, doctors will perform certain tests that look for signs of inflammation in the body. For examples:

Covid-19 test
Blood and urine tests
Chest x-ray
Electrocardiogram (measures electrical activity in the heart)
Echocardiogram (Heart ultrasound)
Abdominal ultrasound
Other tests, depending on signs and symptoms

MIS-C Treatment

Furthermore, kids with the MIS-C syndrome need to monitor for their health by a medical providers at the hospital. Meanwhile, some of them might be admitted to a Pediatric Intensive Care Unit (PICU) due to their critical conditions.

The doctor will provide medicines such as:-

Intravenous Immunoglobulin (IVIG)
Corticosteroids
- Glucocorticoids such as methylprednisolone
- Tocilizumab
Antiplatelet /Anticoagulant therapy
- Aspirin
Antibiotics
- Ceftriaxone + vancomycin
- Clindamycin
Antiviral therapy
- Remdesivir

supportive care may include, for instance:

Intravenous Fluids (dehydration)
Ventilator
In very rare cases, use extracorporeal membrane oxygenation (ECMO)

Moreover, children need to be followed up after discharge from the hospital. Nonetheless, the period of full recovery is about six months. Also, no further follow-up if there are no serious complications.

Apart from that, MIS-C is a treatable condition and most children recover entirely from the disease. Hence, with prompt attention, medications can control the inflammation and help prevent long-term organ damage, especially the heart.

Is it necessary to vaccinate children against COVID-19?

Yes. Vaccines protect children from developing serious complications like multisystem inflammatory syndrome (MIS-C), which infects other organs with inflammation.

However, when your kids diagnose with MIS-C, the doctor must hold the vaccine from being injected. This is because the COVID-19 vaccine needs to be delayed for at least 90 days until they are fully recovered.

The Ministry of Health (Malaysia) is implementing the COVID-19 vaccine for children aged 5 to under 12 years old starting in February 2022. So, the mRNA vaccine Comirnaty® 10 mcg Concentrate for Dispersion (PfizerBioNTech) will be used.

To conclude, the results of a clinical study of this vaccine showed an effectiveness of 90.7% as well as the ability to enhance a high immune response to COVID-19 disease. Therefore, the complete dose requires two vaccine dose injections with an interval of eight (8) weeks after the first dose.

Diagram of MIS-C cases

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About the author

Raihan Ridzuan

Bachelor of Science (Hons) Pharmacology, is a Customer Relationship Executive of Mayflax, one of the nation’s leading healthcare and marketing companies.

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March 14, 2022March 31, 2022

Omicron SARS-CoV-2 variant: What scientists know so far

Omicron SARS-CoV-2 variant: What scientists know so far

The Omicron appears to be a concern today. This virus is very popular among us and has caught our attention due to its unusual mutations. Some are rare and have never existed before.

In late November, the World Health Organization (WHO) classified this variant as a point of concern. A growing number of the cases are being reported across the country at the moment.

But what do we know about this virus so far?

What is the Omicron variant?

Mutations of a virus are inevitable. A new SARS-CoV-2 variant, Omicron (B.1.1.529), was reported to WHO on 24 November 2021 from South Africa, raising alarms among researchers and the global community.

In the bronchi (lung airways), Omicron replicates 70 times faster than Delta, but evidence suggests it is less severe than previous strains.

How did it get its name?

Omicron is the Greek letter “O”, and was named after the 15th letter of the alphabet.

The World Health Organization name the virus as omicron to makes public communication easier, less confusing, and stigma. If using scientific names for the variants, it can be difficult to say and recall. They want it to be simple and accessible to others.

Here are the five current variants:

Alpha – B.1.1.7 (United Kingdom)
Beta – B.1.351 (South Africa)
Gamma – P.1 (Brazil)
Delta – B.1.617.2 (India)
Omicron – B.1.1.529 (South Africa)

The Delta variant is currently the dominant strain all over the world.

Where does the Omicron come from?

This variant is found in South Africa. Over the past few weeks, the Omicron version is spreading throughout the world, faster than any previously known variant.

What are the signs and symptoms of Omicron?

The Omicron variant can infecting person with the symptoms that are similar to the previous covid-19.

All of the variants, including delta and omicron, cause similar COVID-19 symptoms, like cough, fever, and fatigue. There is some evidence that fewer people is losing their taste and smell. Besides that, this virus less likely to causing pneumonia that may require oxygen treatments in the hospital.

Symptoms of Omicron variant

Based on the analysis, neither Delta nor Omicron showing any clear differences in symptom profiles. About 50% experience common signs such as fever, cough, and loss of taste or smell.

Dr. Rahul Sharma from the emergency physician-in-chief at the New York-Presbyterian/Weill Cornell Medical Center said “We’re seeing a lot of sore throat, runny nose, fatigue and mild headache,”.

How fast Omicron spread compared with other variants?

Omicron variants are spreading two or three times faster than Delta.

The earliest evidence for the rapid spread is from South Africa, where it is growing rapidly to dominate one region after another. In other countries, researchers view the cases are doubling every 2 to 4 days.

As a result, the country recording 3,402 cases on 26 November. Then on December 1, it increased to 8,561 cases.

The omicron variant is it more severe than other covid-19 variants?

Bollinger said, “For omicron, there is less data on this,”

Moreover, Omicron is a mutant virus that is still in early stages. World Health Organization classifying Omicron as a Variant of Concern (VOC). This mutation increase transmissibility, and disease severity.

For your information, Omicron is mutated with 43 spike protein mutations compared to Delta is about 18 spikes.

The World Health Organization (WHO)

Early findings suggest that there is a reduced risk of hospitalization for Omicron variant. According to the WHO, an increase in transmission can lead to more hospitalizations.

Thus, it is important to remember that all variants of COVID-19 can cause severe disease or may result in death. Our responsible is preventing the spread and reducing the risk of exposure to the virus is so important right now.

This variant is spreading and infecting other countries. For further study, they need to conduct more research to collect various types of data. The Omicron cases are rising, so the large size of sample such as geographical for researchers can increase a chance for generalizing early reports.

Meanwhile, scientists measured the severity of a coronavirus variant by examining the number of people infected in the hospital. The Delta variant turned out to be much worse than the Omicron variant.

A British study found that the risk of hospitalization due to Omicron is half of the delta.

Is the covid-19 vaccine effective against omicron?

Scientists are studying any potential effects of Omicron variants on the effectiveness of the COVID-19 vaccine. Information is still scarce. However, the effectiveness of vaccines against mild, severe illness and death, may be declining.

Moreover, the WHO reports that, so far, the booster vaccines available provide significant protection against serious disease and death.

For now, it is important to be vaccinated to protect against Omicron and other variants. So, when your turn to get vaccinated make sure you get the doses in order to have the maximum protection to protect yourself and those around you.

Do current boosters provide better protection against omicron?

Yes. Because several studies show that people with full vaccination plus a booster shot have strong protection against the Omicron variant. Without a booster shot, two doses of a vaccine-like Pfizer-BioNTech’s or Moderna’s became less protection to our immune system.

Covid-19 Booster

To see whether the booster improves protection or not, scientists collect blood from patients who are fully vaccine and mix their antibodies with Omicron in a petri dish containing human cells.

Consequently, every vaccine tested so far has performed worse at neutralizing Omicron than other variants. Not only that, antibodies from people who received two doses of the AstraZeneca vaccine or one dose of the Johnson & Johnson vaccine do not seem to have any effect on Omicron at all.

But when researchers tested antibodies from people who had received boosters of Moderna or Pfizer-BioNTech vaccines, they saw a different picture. Many Omicron viruses were blocked from infecting cells by boosted antibodies.

The researchers found that the Pfizer-BioNTech vaccine had a 80% efficacy against Omicron infection.

Can vaccines reduce the severity of Covid?

As I mentioned above, in a large study of more than a million cases of Covid, British researchers found that people who had received booster doses were 81 percent less likely to be admitted to the hospital, compared to people who have not been vaccinated yet.

Those who had received two doses of vaccine had a 65% lower risk of being admitted to a hospital.

How antibodies fight Omicron variant?

Additionally, even people who have had vaccines may be at risk of infection with Omicron. For instance, the variant can evade antibodies produced by vaccines and multiply in the nose and throat. But vaccines not only trigger the production of antibodies against coronavirus, they also stimulate the growth of T cells that help fight a specific disease.

T cells antibody

T cells learn to recognize when other cells are infected with specific viruses and destroy the pathogen. As a result, the infection becomes slow.

To determine how well the Covid-19 vaccine fight Omicron, scientists do research on T cells that produce by the vaccine. Researchers found that these T cells are able to recognize the Omicron variants.

In addition, this preliminary evidence indicates that Omicron infections enable to penetrate the T-cell barrier. By killing infected cells, T cells may make it harder for Omicron to reach into the airway inside the lung tissue.

Are the current covid-19 tests detecting the omicron variant?

Commercial diagnostic PCR (polymerase chain reaction) and available antigen COVID tests can be uses to identify and detect the omicron variant. And yet, we will know more in the coming weeks about how well the rapid at-home tests to detect a new variant.

How long does omicron last on surfaces?

The WHO states that COVID can be transmitted through close personal contact as well as through aerosols in crowded areas and poorly ventilated environments.

Furthermore, people can get the viruses by touching their eyes, nose, or mouth after coming into contact with contaminated objects or surfaces.

Japanese researchers found that Omicron is the most easily transmitted variant of SARS-CoV-2, but a new study found this virus survives longer than any previous variant on plastic surfaces and skin.

Hence, Omicron stays on plastic for about 8 days and on the skin for less than 24 hours.

What can we do to protect ourselves and our families from the omicron variant?

The most important thing we can do is reduce the risk of exposure to the virus. Make the following precautions to protect ourselves and our loved ones:

Wear proper mask

Wear masks that meet a standard with multiple layers of non-woven material such as a 3ply face mask that covers your nose and mouth. Make sure that your hands are clean when you put on and remove your mask.

Physical distance

Keeping a distance of one meter helps limit the spread of COVID-19. Recommended by the World Health Organization.

Avoid poorly ventilated and crowded spaces.

Indoor air quality, ventilation, and occupancy have become growing concerns in the battle to slow the spread of COVID-19.

Open windows to improve ventilation indoors.

If it’s safe to do so, open doors and windows as much as possible to let in fresh air from outside.

Wash your hands regularly.

You can help yourself and your loved ones stay healthy by washing your hands often, especially during this pandemic.

Get a shot

When it’s your turn, get vaccinated. WHO-approved COVID-19 vaccines are safe and effective.

Do Covid tests

Performing Covid tests at home regularly using a device that can detect variants

Precautions such as those outlined above will help prevent the spread of Omicron.

After all, researchers are trying to understand the Omicron variant. “We still have a lot to learn about omicron,” Ray said. WHO will continue to closely monitor the Omicron variant and update it with more information.

In order to protect ourselves from being infected with this virus, we need to do a covid test when we feel unwell or meet a lot of people.

However, test devices can be inaccurate, you should use the one recommended by the WHO. You can buy it at any pharmacy and medical supplier like Mayflax. Mayflax provides a covid-19 self-test kit and you can purchase with us. If you want to know more, click here.

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