BENGALURU: Of 29 children who contracted Covid-19 and were admitted with Multisystem Inflammatory Syndrome (MIS-C) from May to July 2021 at Aster Hospitals (Aster CMI, Aster RV and Aster Whitefield), the male to female ratio was 6:1.
MIS-C occurs two to six weeks after recovery from Covid-19 in children, with symptoms of inflammation, fever, multi-organ dysfunction that not only includes the skin, mucous membranes and heart, but frequently affects the gastrointestinal, respiratory and neurological systems.
“We don’t know the reason for more male children developing the syndrome, as compared to females. World over as well, the findings are similar, with a ratio of 2:1. For us, the ratio was more skewed. All children presented with a history of high-grade fever and most had mucocutaneous findings in the form of red eyes, red lips and red tongue,” said Dr Sagar Bhattad, Consultant - Paediatric Immunology and Rheumatology, Aster CMI Hospital.
As per hospital data, gastrointestinal symptoms, including severe abdomen pain and loose stools were noted in 11 of these children. Of the 29 children, eight presented in hypotensive shock and two required mechanical ventilation.
“MIS-C is a spectrum, and 14 children had BP so low that it was unreadable (hypotensive shock). Two of them needed mechanical ventilation as breathing was difficult. Even after we administered oxygen, they continued to face issues and had to be intubated for 5 to 7 days,” Dr Bhattad added.
Three children presented with a mild disease called Post-Covid Febrile Inflammatory State (FIS). This included high fever and increased inflammation, but they were stable and recovered with symptomatic treatment.
One child with severe MIS-C developed Macrophage Activation Syndrome wherein there is reduced haemoglobin, platelet and White Blood Cell count.
This is the severest form of MIS-C, with a high death rate. This patient was treated with additional biological therapy, using Anakinra and Tocilizumab, and recovered.
Intravenous immunoglobulin and steroids were used in the treatment of 93% of the cases. There were no deaths, and all have recovered.
Dr Bhattad advised the public to remain watchful for two to three months after a child recovers from Covid.
The hospital also saw three more paediatric cases in the past 10 days, where two patients needed ICU.
With increased awareness, multi-disciplinary support and improved understanding of this new disease, early diagnosis and treatment of children with MIS-C is now possible, the hospital said.