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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.

MIS-C in children

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

Diagnosis of MIS-C

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:-

  1. Intravenous Immunoglobulin (IVIG)
  2. Corticosteroids
    • Glucocorticoids such as methylprednisolone
    • Tocilizumab
  3. Antiplatelet /Anticoagulant therapy
    • Aspirin
  4. Antibiotics
    • Ceftriaxone + vancomycin
    • Clindamycin
  5. Antiviral therapy
    • Remdesivir

supportive care may include, for instance:

  1. Intravenous Fluids (dehydration)
  2. Ventilator
  3. 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.

MIS-C cases picture

Diagram of MIS-C cases

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About the author

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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