STAY STRONG
MIS-C During the Era of COVID-19
What is Multisystem Inflammatory Syndrome (MIS-C) in Children?
MIS-C is a condition where children present
with fever and inflammation of different body parts,
such as the heart, the kidneys, the gut,
the lungs, and even the skin.
The first cases were reported in the UK
where an alert end of April came out on children
who presented a month after the peak of COVID-19 in the UK
with fevers, low blood pressures, and who were very sick.
Similarly, we have seen in New York,
which happens right now to be the hotspot for MIS-C,
a surge of these cases,
where again, children are presenting
with fever, rashes, abdominal pain, vomiting, and diarrhea.
And this has happened again a month
after COVID-19 peaked in New York.
So far, we have close to 200 cases in New York State.
What causes MIS-C?
We don't know yet what causes MIS-C.
Yet what we do know is that children with MIS-C
either have had the virus that causes COVID-19,
or have been exposed to someone with COVID-19.
What are the Symptoms of MIS-C?
Children with MIS-C present with fever
and any of the following symptoms;
such as abdominal pain, vomiting, diarrhea,
skin rash, bloodshot eyes, red and swollen hands and feet,
red lips, and feeling unusually tired and sleepy.
Those symptoms may not appear all at once.
If your child develops any of those symptoms,
you should continue to follow them and contact your doctor.
If your child is unable to stay awake,
if your child has difficulty breathing,
or has severe abdominal pain,
you should contact 9-1-1,
or take your child to the nearest emergency department.
What is the treatment for MIS-C?
The treatment of MIS-C is tailored
to your child's symptoms and condition.
At the children's hospital at Montefiore,
we provide supportive care to your child's condition.
Some children might require care
in the pediatric intensive care unit,
and others might be receiving medicine
to treat inflammation.
All of our patients have recovered.
Here at the children's hospital at Montefiore,
we have established one of the first MIS-C programs
in New York City designed to provide multidisciplinary care
to children with MIS-C
who have been discharged from the hospital.
It is important to monitor their inflammation,
and to gain better understanding of this disease.
For that reason,
we see these children a week, a month,
and we plan to see them up to a year
after they leave the hospital.
A team of specialists in cardiology, infectious disease,
rheumatology, and blood disorders sees these children
with MIS-C either in in-person visits
or through Telehealth visits.
How does MIS-C resemble and differ from Kawasaki disease?
In order to understand the similarities and differences
between MIS-C and Kawasaki disease,
it's important to understand what is Kawasaki disease.
Kawasaki disease is an illness of childhood
that results in inflammation of blood vessels,
mainly the coronary arteries,
which are the arteries that supply the heart with blood.
Children with a MIS-C present with some symptoms
that are similar to Kawasaki disease.
And that includes the rash and the bloodshot eyes.
And in some children with MIS-C,
we have seen inflammation of the coronary arteries.
Yet in MIS-C, children are older.
In Kawasaki disease,
Children usually range in age from six months to six years.
We have seen MIS-C in kids older than six years of age.
Also in MIS-C, children tend to present sicker,
and with higher level of inflammation
than we have seen in Kawasaki disease.
Are there children more at risk for MIS-C?
Unlike COVID-19 which affected older adults
with preexisting conditions,
such as heart disease, obesity, and diabetes,
children with MIS-C have been previously healthy.
Doctors have not been able yet to identify risk factors
that put children at a higher risk
for developing this disease.
(gentle music)