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Some children with COVID-19 may experience rare inflammatory syndrome

Sep. 10, 2020, 2:33 PM


by Christina Echegaray

With cases of COVID-19 increasing among young children and adolescents in Tennessee, pediatric infectious disease experts at Monroe Carell Jr. Children’s Hospital at Vanderbilt have started to see cases of a mysterious illness believed to be connected to COVID-19, known as multi-inflammatory syndrome in children (MIS-C).

In children with MIS-C, different parts of the body can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.

Tennessee has seen fewer than 10 cases of MIS-C, according to Centers for Disease Control and Prevention (CDC) data. Meanwhile, the state has had more than 29,000 cases of COVID-19 among patients 20 years and younger, according to state data.

Children’s Hospital has treated five children for MIS-C since mid-July.

While MIS-C is still rare, experts at Children’s Hospital are advising parents on what symptoms to look for, especially in children who have or have had COVID-19, since doctors believe the two are related. MIS-C can be serious and life-threatening, but if caught early can be successfully treated.

“The estimates are that around 90% of children who have MIS-C have evidence of COVID-19 or have had COVID in the recent past,” said Ritu Banerjee, MD, associate professor Pediatrics and Pediatric Infectious Diseases. “There appears to be a strong relationship between COVID-19 and MIS-C, but what we don’t understand is why, though we think it is an inflammatory response. We can’t predict which children will get MIS-C and why some children develop these symptoms.”

MIS-C symptoms, which are believed to develop 2-4 weeks after COVID-19 infection, include:

  • Fever
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Neck pain
  • Rash
  • Changes inside the mouth, i.e. red tongue
  • Bloodshot eyes
  • Swelling of hands and feet
  • Feeling extra tired

Parents should contact their child’s doctor if the child shows symptoms of MIS-C. More severe symptoms requiring emergency care include trouble breathing, pain or pressure in the chest that doesn’t go away, new confusion or difficulty waking or staying awake.

Banerjee stresses that MIS-C is extremely uncommon. Put into perspective, early data shows that only 2 in 100,000 people under age 21 will develop the inflammatory syndrome. For COVID-19, numbers show that about 322 per 100,000 people under age 21 will develop infection with the novel coronavirus.

As of Sept. 3, the CDC website reported 792 confirmed cases of MIS-C and 16 deaths in 42 states, New York City and Washington, D.C. The average age of these inflammatory cases is in children between ages 1 and 14. The disease also has disproportionately impacted Black and Hispanic communities, with 70% of MIS-C cases affecting these demographic groups.

“Most children will be just fine after a COVID-19 infection, and when we do diagnose MIS-C, it is treatable,” Banerjee said. “The best way to prevent MIS-C is to prevent COVID-19 infection in the first place — so that means practicing social distancing, masking and good handwashing.”

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