October 6, 2021

Pediatricians seeing increase in children with MIS-C after latest COVID surge


by Jessica Pasley

More than 195 cases of multi-system inflammatory syndrome in children (MIS-C) have been reported statewide since May 2020, according to Tennessee Department of Health data.

The number of cases has more than tripled since early February when the Center for Disease Control and Prevention (CDC) showed about 51 cases in Tennessee.

Sophie Katz, MD, MPH

Pediatricians at Monroe Carell Jr. Children’s Hospital at Vanderbilt said the numbers are expected to increase in the coming weeks, which is the typical pattern after a COVID-19 surge.

“We saw a dramatic increase in COVID-19 cases in children over the past two months with the delta variant surge in our region,” said Sophie Katz, MD, MPH, assistant professor of Pediatric Infectious Diseases at Children’s Hospital. “Unfortunately, we anticipate an increase in MIS-C cases following this spike. The trend is three to four weeks post COVID exposure.”

Although MIS-C can be serious, it’s still relatively rare, Katz stressed. It can occur in children who don’t know they were exposed to COVID-19.

  • Children’s Hospital has treated approximately 70 children for MIS-C since mid-July 2020, with 20 of those in the last month.
  • The state has had more than 255,000 cases of COVID-19 among patients 20 years and younger, according to a recent American Academy of Pediatrics report.
  • As of Aug. 27, the CDC website reported 4,661 confirmed cases of MIS-C and 41 deaths in 49 states, New York City, Puerto Rico and Washington, D.C. The average patient age is between 5 and 13 years.
  • The disease has disproportionately impacted Black and Hispanic communities, with 61% of MIS-C cases affecting these demographic groups.

While serious, the illness is extremely uncommon, causing inflammation in different parts of the body including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.

Experts at Children’s Hospital are advising parents on what symptoms to look for, especially in children who have or have had COVID-19. MIS-C can be serious and life-threatening, but if caught early it can be successfully treated. It is not contagious.

MIS-C symptoms 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

“MIS-C can affect the heart, and that’s why we take it so seriously. Parents should call their doctor if their children develop these symptoms. 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,” Katz said. “Of the children who have been seen in our outpatient MIS-C clinic, all are back to their baseline health by one month after hospital discharge.”

Doctors don’t know why some children develop MIS-C while others don’t, but there are research studies being conducted throughout the country to gain insight into the syndrome. They stress that the best way to prevent MIS-C is to prevent COVID-19 infection in the first place.

“A small proportion (about 20%) will shed COVID-19 while they have MIS-C,” added Katz. “Maintaining the usual strategies to prevent COVID-19 exposure are still important — wear your mask, wash your hands and, if eligible, get vaccinated.”