MIS-C: Children with Coronavirus Inflammatory Syndrome Need Help Quickly

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Symptoms are not like the classic symptoms of coronavirus and can mainly include stomach pain and vomiting, as well as fever and possibly a rash, experts told other doctors at a time. meeting organized on Tuesday by the United States Centers for Disease Control and Prevention.

It is becoming clear that many children with the new syndrome have heart damage and need immediate treatment, they said during the clinician outreach and communication (COCA) briefing. And they believe it is becoming increasingly clear that Covid-19 is involved, although many children tested negative for the virus at first and never appeared to have any symptoms of infection.

The syndrome appears to develop two to six weeks after infection with Covid-19 and mainly affects children who were previously perfectly healthy. The CDC issued a health alert last week to warn pediatricians of the watch, and at least 20 states and Washington, DC have reported that they are investigating possible cases.

“A striking finding here – alarmingly – is that about half of the children in this group already had coronary artery abnormalities,” said Dr. James Schneider, who heads pediatric intensive care at Northwell Health in New York. Because the children were previously healthy, he believes the abnormalities were caused by MIS-C, possibly due to a delayed immune response to the coronavirus.

“Any child at home who has a fever, abdominal pain or symptoms such as rashes and conjunctivitis should be seen immediately by a pediatrician,” he advised. “I think we have to have a low cut-off point. “

“Alarming” results

More than half of the 33 children treated for MIS-C at Northwell in April and May had developed some sort of heart dysfunction, said Schneider. “They need good old-style intensive care. “

And most children had no underlying condition that could make parents suspicious. “There are no definitive underlying conditions predisposing children to it,” he said.

Infectious Disease Specialist Dr. Nicholas Rister at the Cook Children’s Medical Center in Fort Worth, Texas, said he had examined several children with various symptoms.

“I feel very bad – some patients have said, you know, everything that hurts. And then swelling in various parts of your body, especially your hands and feet, and even your mouth, “he said in a separate briefing.

“The biggest concern we have right now, especially in children, is largely due to the inflammation around the heart,” he said. This is one of the reasons why doctors first thought that the syndrome was a rare condition known as Kawasaki disease. “And not just the heart but the main vessels around the heart,” he added.

CDC warns doctors about childhood illnesses linked to Covid-19

Dr. Michael Levin of Imperial College London, who treated some of the first patients in Britain, said parents may be reluctant to bring their children, but they should be.

Some of the children he and his colleagues treated were already seriously ill when they arrived at the hospital. “One of the reasons could be the lockdown and fear of coming to the hospital,” he said. “The public health message in the UK was that patients should try to stay at home and not go to the hospital,” he added. The children therefore stayed at home with a fever… and arrived in a seriously ill condition. “

Blood tests will quickly tell doctors if children may have MIS-C, said Levin. Inflammation and heart damage tests can show if children are at risk and need to be hospitalized.

Rapid treatment appears to be working, and most children go home after a few days in the hospital, said Schneider and Levin.

Levin said most of the children were initially negative for Covid-19 infection, but later tests indicated that they likely had an infection before.

He said these young patients had symptoms of an extreme inflammatory response. “There is concern that we are witnessing a deregulated immune response,” said Levin during the briefing. “The time of this disease seems to coincide with the time when acquired immunity would develop. “

Many children in England who have been diagnosed with MIS-C are from ethnic minorities, said Levin. “There appeared to be a predominance of children of black, African, Caribbean-British descent who accounted for approximately 46% of the cases,” he said.

Twenty-seven percent of children with the disease in a recent New York study were Hispanic, said Schneider of Northwell.

Shelby Lin Erdman contributed to this story.

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