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Monday Medical: Understanding multisystem inflammatory syndrome in children

As COVID-19 continues to spread, doctors are keeping tabs on the multisystem inflammatory syndrome that has cropped up in children who either had or were exposed to the virus.

The good news is that the syndrome, called MIS-C for short, is uncommon.

“As of Jan. 11, the state was reporting 29 cases,” said Dr. Dana Fitzgerald, a pediatrician in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “It’s still very rare and is not something we’re seeing on a regular basis.”



However, it can be serious. Fitzgerald outlines what to know about this new condition below.

What causes MIS-C?

While the cause isn’t clear, the syndrome crops up two to four weeks after a child has been infected with or exposed to COVID-19.



“There’s certainly a lot we’re still trying to figure out,” Fitzgerald said. “This type of condition is new post-COVID, and we’re still trying to get a handle on it.”

What are the symptoms?

MIS-C causes inflammation across various organs and tissues, which makes children very sick. High fevers, severe abdominal pain and GI issues, such as nausea, vomiting and diarrhea, are all typical symptoms.

A child suffering from MIS-C may also have red eyes, red and swollen hands and feet, cracked lips and strange rashes. Those symptoms are similar to Kawasaki disease, which causes inflammation of the blood vessels.

“These aren’t just kids who vomit and feel miserable, then take Tylenol, rest and feel better,” Fitzgerald said. “These are really, really sick kids, and they need to be evaluated.”

How is MIS-C diagnosed?

To diagnose MIS-C, a child should be examined by a health care provider. Various lab tests may be run to look for inflammatory markers, organ dysfunction, electrolyte abnormalities and even heart issues.

The COVID connection

Parents should remember that they may not be aware their child had COVID-19, as many children only have mild, cold-like symptoms.

“In kids, COVID-19 often looks like a regular cold,” Fitzgerald said. “You don’t tend to see high fevers, a cough or super-sick kids. You can see that, but a lot of the time, kids just have mild cold symptoms.”

That’s one reason Fitzgerald strongly recommends getting children tested for COVID-19 any time they have cold symptoms.

“The really important thing to get across to parents is that because COVID can look like a regular cold in kids, we want to make sure those kids get tested so we can quarantine and isolate, so it’s not spreading,” Fitzgerald said. “I get a lot of parents who think their kid just has a regular cold, but I can’t tell you that it’s not COVID without testing.”

How is MIS-C treated?

While treatments are still evolving, the current regimen includes steroids, immunoglobulin administered through an IV and close monitoring to determine whether specialty care, such as precautions to prevent heart failure, are needed. Children with MIS-C are cared for by a pediatric specialist.

To Fitzgerald, it’s another reminder that COVID-19 is serious.

“This is the thing that gets me so worried about COVID in general — it seems to randomly affect otherwise healthy people,” Fitzgerald said. “Yes, the vast majority are fine, but the people that get sick can be so, so sick.”

Can MIS-C be prevented?

The best way to prevent MIS-C is to prevent the spread of COVID-19.

“Initially when this all started last spring, we didn’t really have a lot of data. Now we’re finding that wearing a mask, washing your hands and keeping social distance help,” Fitzgerald said. “We need to pull together as a community and watch out for each other and for our high-risk community members by doing these things.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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