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11-year-old Aarav is running a high fever. He only had COVID-19 a few weeks ago. His mother worries if he's now contracted another serious illness like dengue, or perhaps typhoid.
Aarav's paediatrician diagnosis him with MIS-C, a rare inflammatory condition in children that has now come to be almost exclusively associated with COVID-19.
Mounting data shows that COVID can raise a person's risk of cardiovascular issues that can last for months after recovery.
To better understand this post COVID condition, FIT spoke to Dr Maninder Singh Dhaliwal, Associate Director, Paediatrics, Medanta Hospital Gurugram, and Dr Sameer Sadawarte, HOD & Sr. Consultant-Paediatric, Fortis Hospital, Mulund.
Multisystem inflammation syndrome is a rare, but serious post COVID complication that develops as a result of a child's immune system going into overdrive.
As a result, the body's immune system itself starts damaging it.
Symptoms of MIS-C are also multisystem. "It causes a fire in the body, and it can also have a heart involvement where the heart blood vessels become dilated. There are also GI (Gastrointestinal) symptoms," says Dr Dhaliwal.
Inflammation can happen with other viruses too, but this word, is now pretty much exclusively attached to COVID-19.
Dr Sadawarte explains that children usually develop either mild or asymptomatic COVID, but a history of COVID or COVID like symptoms in the family could give a doctor the clues required to diagnosing MSI-C.
This is also why it's important to monitor any unusual symptoms in kids and consult a paediatrician as early as possible.
According to the experts we spoke to, some common tells of MIS-C are
Rashes on the body
Headache
Abdomen pain
High grade fever
Low blood pressure
Diarrhoea and Vomiting
Breathlessness
Both Dr Sadawarte and Dr Dhaliwal explain that while there is no way to predict or prevent MIS-C, children with pre-existing comorbidities like renal issues may be more susceptible.
MIS-C in kids has been around for as long as COVID has. In fact, says Dr Sadawarte, things were much worse in the first two waves.
"From 2020, we first noticed cases in the month of may. At the time we used to get more number of cases. In the last four to five months, the number of cases that are coming in has reduced," says Dr Sadawarte.
Dr Dhaliwal on the other hand says that while the number of cases are lower now than during the second wave, it's too soon to declare a win.
"We are not seeing more patients, but we are seeing more neonatal MISC," says Dr Sadawarte.
He goes on to talk about how babies born to women we had COVID-19 at some point during their pregnancy are more likely to develop it.
"Mother's COVID, during pregnancy in the prenatal period can actually cause neonatal MISC."
A reason why MIS-C may be missed in newborns is because it's not standard practice to check their antibodies, says Dr Sadawarte
"All the 2 cases that have now been referred to us from other hospitals because they were having issues and the patients were not getting better. And here we diagnosed them with neonatal MIS-C," he adds.
But, says Dr Dhaliwal, "MIS-C is a life-threatening condition. Most of the cases of MIS-C will be admitted to the ICU with low blood pressure, and high fever."
Which is why it's extra important to be sure it is MIS-C before beginning treatment.
Vaccines, Dr Dhaliwal, says—quoting studies conducted by the US Center for Disease Control and Prevention—can help lower the risk of MIS-C in kids.
"That vaccination prevents MIS-C is a new fact," says Dr Dhaliwal.
According to data collected by the US CDC, 2 doses of the Pfizer-BioNTech vaccine (which has been approved for children over the age of 5) was estimated to prevent MIS-C by 91 percent. The CDC also says that critically ill MIS-C case-patients requiring life support in the US, were all unvaccinated.
However, it must be noted that this data only applies to mRNA COVID vaccines, and there isn't much we know about how other vaccine platforms work against MIS-C.
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