Reeyan Ahmed,16, felt his heart rate rising as he sat in his high school classroom. On his fitness tracker, his pulse spiked to 170 beats per minute. Minutes later in the school nurse’s office, his heart rate reached 201. That wasn’t the first time Reeyan experienced tachycardia (a heart rate over 100 beats a minute).
For a little over a year, the Murfreesboro, Tennessee, teen has battled the aftermath of multisystem inflammatory syndrome in children, or MIS-C. Among his symptoms is myocarditis, or heart muscle inflammation, and sharp chest pain.
MIS-C is a rare and potentially life-threatening illness that develops about four weeks following COVID-19 and can cause different parts of the body to become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, often resulting in hospitalization.
Following each of the previous COVID-19 surges, providers at Monroe Carell Jr. Children’s Hospital at Vanderbilt saw spikes in the number of children treated with MIS-C. While doctors aren’t sure if the omicron variant will produce the same increases in MIS-C cases, they want parents to know what to look for. Since the start of the pandemic in 2020 about 100 children have been admitted to Children’s Hospital for MIS-C.
“We know that MIS-C can be prevented by preventing COVID-19 infection in the first place with all the tools we know work — wearing masks, distancing, washing hands, isolation of COVID-infected individuals. Most importantly, all eligible children and adults should be vaccinated,” said Ritu Banerjee, MD, professor of Pediatric Infectious Diseases at Children’s Hospital. “We may see less MIS-C than after other surges as more children are vaccinated now, and there is good evidence that vaccination protects against the development of MIS-C.”
Doctors are hopeful that as more children are vaccinated, they will see less MIS-C.
A study released in January of data compiled by children’s hospitals nationwide, including Children’s Hospital, showed that the risk of MIS-C is reduced by about 90% in children who are vaccinated compared to those who are not. Natasha Halasa, MD, a pediatric infectious disease expert at Children’s Hospital, was a co-author.
Reeyan is sharing his story to augment doctors’ messages around MIS-C and the COVID-19 vaccine. In the U.S., there have been about 6,851 reported cases of MIS-C in children, including 59 deaths. While rare, Reeyan doesn’t want one more child to get it.
In between classes and extracurricular activities, Reeyan raises awareness about MIS-C. He also developed a video message for local pediatricians in collaboration with the Cumberland Pediatric Foundation.
“He’s had a trying year with everything that has happened, and he wants to get the word out that this isn’t a joke. He wanted to be a cardiologist even before this happened. He wants to help as many people as possible,” said Reeyan’s mother, Karmen Oneal. “As a parent, seeing your (at the time) 15-year-old son have chest pains is awful.”
Reeyan also doesn’t want parents to experience what his mom went through, noting, “It’s critical that parents get their children vaccinated so no parent has to watch their child with chest pains, feeling sick, while knowing there is nothing they can do.
“I also want to get the word out so that if kids had COVID, their parents know what to look for and that they should take it seriously,” he added.
Reeyan, along with his mother and two older sisters, had COVID in December 2020, before vaccines were available. About five weeks later, he developed symptoms that he now knows were MIS-C: a 104-degree fever, very red, bloodshot eyes, neck pain, headache, vomiting and lethargy. Tests for flu, strep, COVID and mono were all negative.
“I couldn’t eat or drink anything. I lost 7 to 8 pounds. I felt like I was having an out-of-body experience,” he said.
By chance, his sister had an appointment with English Flack, MD, MS, a pediatric cardiologist for Children’s Hospital. Oneal mentioned Reeyan’s symptoms to get input from Flack, who said he needed to be seen and tested for inflammatory markers and cardiac biomarkers. His markers were elevated, indicating inflammation in his body.
Reeyan was also Flack’s patient, having previously seen her for chest pains and palpitations, but no abnormality had ever been documented with his heart.
A cardiac MRI in March 2021, following his MIS-C illness, revealed myocarditis, which can lead to decreased heart function. To be safe, doctors put Reeyan on physical restrictions for six months. He couldn’t even carry a backpack.
“Following the MIS-C, I was having chest pains — not my normal chest pain, but kind of like a stabbing pain and pressure,” he said. “It was really scary.”
To help doctors learn about MIS-C, Reeyan joined a clinical trial to study the syndrome. He was seen at regular checkups in the MIS-C Clinic at Children’s Hospital, seeing Flack (for cardiology), Natasha Halasa, MD, (pediatric infectious diseases) and Anna Patrick, MD, (rheumatology). He is 1 of about 100 patients followed in the MIS-C clinic.
“We have seen the full spectrum of MIS-C illness, from mild to severe,” said Flack. “Our MIS-C patients, Reeyan included, have had similar abnormal patterns in their cardiac MRI results, and we’re still researching and learning what this will mean for them in the months and years to come. And just like so many things with COVID, we don’t know the long-term cardiac effects.”
Flack also noted that myocarditis can also occur following an initial COVID infection, and that according to an American Academy of Pediatrics’ recommendation, parents should notify their family doctor if a child had COVID so it can be documented in their medical record.
Reeyan is now a year out from having MIS-C, and all physical restrictions have been lifted. He had to delay his COVID vaccination because of his heart issue, but he should be able to get it in May, he said.
“I’m feeling pretty good. Occasionally, I get pressure and the chest pain, but I’m back to being able to do all the things I used to. I’ve been doing exercise on the treadmill every night,” he said.
For Oneal, she is grateful that Reeyan has continued to improve. “We count our blessings every day,” she said.
