Multisystem Inflammatory Syndrome in Children - Signs, Causes and Treatment

The SARS CoV-2, the infamous virus that causes Covid-19, has changed our lives to an unimaginable extent. No one is still sure about this virus – the way it impacts, the extent of the impact, the mutations, the rate of spread, just about everything about this virus is still under research. One of the main areas of focus has been how this virus is affecting the younger generation – the future of mankind. Multisystem Inflammatory Syndrome in children seems to be one such complication having a severe impact.

What is Multisystem Inflammatory Syndrome in Children?

Multisystem Inflammatory Syndrome In Children (MIS-C) is a condition that affects the entire body. It causes severe inflammation in various parts and organs of the child’s body. As children are not severely impacted by Covid-19, the knowledge about this delayed side effect is very limited.

As of now, there is not much data on MIS-C. It is classified as a syndrome instead of disease due to the lack of sufficient data and information about the same. Experts believe it to be a complication arising from the dysregulated response of the immune system to the Covid-19 infection.

Causes of Multisystem Inflammatory Syndrome in Children

There is not enough intel about the causes of this deadly syndrome. As of now, Covid-19 is the only known source of this syndrome.
Children who have been infected with the Covid-19 virus seem to suffer this complication at a much later date.

FstraMIS-C, a severe inflammation seen in various parts of the body, is a very rare and delayed complication of COvid-19 infection.

Few children who have been infected with the Covid-19 virus or exposed to it in close quarters, seem to develop this severe complication a few weeks after recovering from the infection.

MIS-C is seen to surface around 2-6 weeks after the Covid-19 infection.

Hence, for now, the cause for MIS-C is limited to Covid-19. Since this is a very rare complication, not many cases have been reported. So, there is not enough data to conclude anything about this syndrome.

[Read : Coronavirus in Kids]

Is Multisystem Inflammatory Syndrome in Children Contagious?

Though it is a complication arising from Covid-19 infection, it is not contagious. So, if a child develops MIS-C, it will not transfer to other children or adults around them. If you suspect your child might have MIS-C or is showing the classic symptoms, don’t worry about them infecting their peers.

Multisystem Inflammatory Syndrome affects adults too. This is also suspected to be due to Covid-19 infection. However, that is not the scope of this article. Let us focus on how this deadly virus can cause such a rare complication in our children.

Symptoms of Multisystem Inflammatory Syndrome in Children

A lot is still unknown about this new complication in children caused by the Covid-19 virus. According to the data collected so far, some of the symptoms you need to watch out for are

Persistent fever that lasts more than 24 hours – can even be present for days together
Child looks very ill
Fatigue
Red eyes
Rash
Pain in the abdomen
Loss of appetite
Vomiting
Diarrhea
Reduction in the intake of fluids

Almost all of these symptoms are common and can indicate any other illness or even regular viral infections. These symptoms can present themselves in various combinations or severity. The symptoms and signs are not standard.

How to Recognise the Possibility of MIS-C in Children?

It can be very difficult to even consider the MIS-C possibility, especially since your child just recently recovered from Covid-19. Your main concern would be if the Covid-19 virus is still present in the body or is making a comeback. If your child has just recovered from Covid-19 in the last couple of weeks or has been exposed to an infected person, in close quarters, the child must be checked for not only Covid-19 but for MIS-C too.

Looking Out For Inflammations

MIS-C features signs and symptoms similar to Kawasaki disease and Toxic shock syndrome. Both these diseases cause severe inflammation in various parts of the child’s body. MIS-C can cause severe inflammations in:

Heart
Kidney
Brain
Lungs
Eyes
Digestive organs

Inflammation in one or more of these areas will cause some of the earlier mentioned symptoms. Hence it is important to closely watch your child for any such symptoms after recovery from Covid-19 infection.

Areas of Inflammations in MIS-C

We can further categorize these inflammations based on the part of the body they affect.

Mucous Membrane: This membrane produces thick mucus to protect the organs underneath. Inflammation can result in red or bloodshot eyes, rash, swollen hands or feet, cracked lips, inflammations in the mouth, strawberry tongue (swollen tongue with red spots resembling a strawberry).
Heart: Inflammation results in clammy or sweaty palms, low blood pressure, laboured breathing, shortness of breath along with exertion, high heart rate, arrhythmia.
Gastrointestinal Tract:Inflammation causes severe pain in the abdomen, vomiting, diarrhoea.
Lungs: Inflammation results in shortness of breath, cough.
Neurological: Inflammation results in sudden confusion, headaches, neck pain, tingling sensation in hands, seizures.

Diagnosing Multisystem Inflammatory Syndrome in Children

Diagnosing MIS-C is very tricky. Since there is not much data about this and not many kids have been impacted by this complication, anyone can miss MIS-C or mistake it for something else.

Covid-19 itself can be missed in kids as the symptoms are very similar to the common flu. When the infection is mild in a child, a parent or a doctor does not see the need to get them checked for Covid-19.

Tests to Diagnose MIS-C in Children

With the limited knowledge available, here is how your doctor can possibly diagnose MIS-C:

Blood tests
Chest X-ray
Ultrasound of the abdomen
Echocardiogram – an ultrasound of the heart
Scans of other organs that they suspect an inflammation in

Since this syndrome presents symptoms very similar to that of Kawasaki disease and toxic shock syndrome, it is easy to diagnose it wrong. If the symptoms are very similar to one of these two diseases, the doctor will need more tests until they can finalize the MIS-C diagnosis.

As MIS-C is a very rare side effect or post-infection complication, many doctors might not even consider this possibility. So, they might diagnose it as Kawasaki disease first but later change the diagnosis to MIS-C when they have more proof for the same.

When to See a Doctor For Multisystem Inflammatory Syndrome in Children?

If your child shows any of the symptoms mentioned earlier, it is essential to consult a doctor right away. Inform the doctor about the Covid-19 infection or exposure, so that the doctor has all details available, to make a diagnosis.

Get to a doctor right away if you notice any of the following in your child:

Trouble breathing (inflammation of the lungs)
Red eyes or blurry vision (inflammation of the eyes)
Severe stomachache (inflammation of the digestive organs)
Chest pain or severe pressure in the chest (inflammation of the heart)
Confusion (Inflammation of the brain)

Steps in Treating MIS-C in Children

Hospitalization of the child is a must if they are diagnosed with MIS-C. They cannot be sent home with a list of medicines like they were sent when they had Covid-19. Since inflammation can occur in any or multiple parts of the body, the treatment will vary depending upon the area of impact.

Treating the Inflammation

If the inflammation is in the beginning stages or mild, the doctors use mild medications to bring down the inflammation. The aim is to bring the inflammation under control first, as allowing it to progress will only cause more damage to the organ. Once the inflammation is under control, the doctor will then provide treatment to repair the damage caused.

Hospital Admission

Sometimes, if the inflammation is severe and has deeply impacted the organ, the child might have to be admitted to the ICU. The doctors will keep a close watch and take regular tests to ensure the inflammation is not increasing.

Since this is a new condition with limited data, there are no set treatment protocols. Many diseases involve severe inflammation of various parts of the body. The doctor might try to treat the inflammation in certain parts with tried and tested methods, while some inflammation might require a combination of medicines or treatment.

It all depends on how your child reacts to the medication and treatment too. If they are not responding well to a certain medicine that is generally used to control the inflammation in the heart, the doctor will have to try another way to treat it.

Post-Recovery Precautions

Once the child recovers and gets discharged from the hospital for MIS-C, they need follow-up check-ups. Repeated echocardiograms will be taken to ensure the inflammation is under control. The doctors need to be absolutely sure the inflammations are not returning or causing any other complications in the body.

Recovery From MIS-C in Children

While most children recover very well from the Covid-19 infection, unlike many adults, some children seem to be greatly affected. When the impact is bad enough for them to be hospitalized for many days or require ICU care, this complication may arise.

The data is insufficient as not all children who were hospitalized for a severe case of Covid-19 have reported developing MIS-C, a few weeks later. So, it does not affect everyone equally. This is a complication noted 2-6 weeks after a child recovers from Covid-19 infection and may develop in less than 1% of children infected with this virus.

Are There Any Complications Of Multisystem Inflammatory Syndrome in Kids?

As of now, no sufficient data is available about the complications of MIS-C. Most of the children who were hospitalized for MIS-C have been treated successfully. Only a very few have had fatal endings.

Top 6 Ways to Prevent MIS-C in Children

A lot is still unknown about this syndrome. As of now, doctors and scientists only know MIS-C as a post-complication of the Covid-19 infection or exposure. The best way to prevent this serious complication would be to prevent the infection itself.

As a parent, you can’t do much. You cannot keep your child locked up at home fearing a Covid-19 infection. Children need to go out to school, play in the open, and have a childhood. However, you can teach them to be careful and diligent, to keep themselves safe from being infected with Covid-19.

Here is what you can teach your child:

1. Mask-Up

Ask them to always wear a mask. Ensure these are at least two layers if not three layers of masks. Printed masks with just a single layer may look attractive to the kids, especially if they have their favourite characters on them. But they won’t effectively protect your child from Covid-19 infection.

2. Wash Hands

Teach them to wash their hands well with soap. Follow WHO recommendations of washing hands well with soap. Children can rush through this process as they are always in a hurry.

3. Avoid Crowds

Keep children away from crowds. They may want to visit the malls and other crowded areas. After many months of staying locked in, it is very natural for them to want to go out. Patiently explain to them the danger around.

4. Maintain Social Distance

Do not let them interact or move closely with people who have a severe cold or high fever. If someone in their group shows Covid-19 symptoms, it is more important for your child to maintain a distance.

5. Sanitize

Give them a bottle of sanitizer. Let them carry it and use it when washing hands is not a feasible option.

6. Avoid Touching Face and Surfaces

Teach them not to touch their face unnecessarily. Touching a contaminated surface and touching their eyes, ears or nose can cause infection.

Despite all precautions and vaccinations, many are getting infected with Covid-19. While the infection is mild in some, there are cases of severe infections with fatal endings too. Research is still underway to understand this virus and its impact on humans.

So, if your child does get infected with Covid-19, do not panic. Get them the right treatment and ensure they are safe and do not infect others around them. Watch out for any post-infection complications. Ask your child to keep you informed too.

If your child were to get MIS-C, catching the inflammations early can help them recover fully, with effective treatment.

[Read : What Is the Treatment for the Coronavirus Disease]

Precautions to Avoid Multisystem Inflammatory Syndrome in Children

In the current Covid-19 situations where staying indoors and avoiding hospitals is the most effective way of keeping the virus at bay, it may be tempting to wait for the symptoms to subside. If it is a little older child, they may even shrug off the symptoms to continue with their day-to-day life.

However, it is not a wise choice to ignore such strong symptoms. It is not advisable to let the symptoms get serious until you consult a doctor either. When you feel something is not right with your child and they are not getting any better, it is always advisable to consult a doctor.

If going in person is scary for you, especially just after your child has been hospitalized or treated for Covid-19, try to get an online consultation. Taking more time and delaying as much as possible might complicate things further.

Inflammations when caught at the right time can be treated effectively. The majority of the children who were hospitalized due to MIS-C complications post their Covid-19 recovery have been treated successfully. So, act instead of fearing.

Can Covid-19 Vaccination Prevent MIS-C in Children?

The covid-19 vaccine can prevent MIS-C by preventing the Covid-19 infection itself. However, there is limited data to make any conclusive statement. It would be best to vaccinate your child once the vaccine is available for the particular age group.

The COVID-19 virus is still a puzzle to doctors and scientists. A lot of research is going into this virus as it has stopped the entire world in its tracks. Side effects of this virus are still under study and as time reveals more about this deadly virus, doctors are using the best research and details available, to protect mankind.

As of now, MIS-C is a very rare complication. Not many children have come back to the hospital with this complication, after their Covid-19 infection. Hence the lack of data to analyze and understand. So, do not worry unnecessarily, unless your child shows any of the symptoms mentioned in this article.

With that being said, it is always safer to keep a close watch on a child and consult a doctor without any delay.

Multisystem Inflammatory Syndrome in Children – Signs, Causes and Treatment