KOCHI: Multisystem Inflammatory Syndrome in Children (MIS-C), the post-Covid complication is haunting children with increased health risks. A recent study conducted by a team of doctors found that 71 per cent of MIS-C patients in Kerala developed conjunctivitis and 15 per cent were found to have meningismus—symptoms similar to meningitis— among other symptoms including fever, diarrhoea and cardiovascular issues.
The study was conducted by doctors at Amrita Hospital in Kochi in collaboration with Baby Memorial Hospital, Kozhikode. The study was conducted on 41 MIS-C patients in the state. “The pathogenesis of MIS-C is not well understood. There is no diagnostic test and the risk factors for the development of MIS-C remain unknown,” said Dr Suma Balan, Rheumatology department, Amrita Hospital, Kochi. The MISC patients were categorised into three groups based on age-less than 5 years; 5-12 years and 12-20 years.
“A total of 41 cases were diagnosed with MIS-C and treated at the two tertiary care centres where the hospital conducted the prospective group study between March 2020 and April 2021. The mean age of onset of the condition was 6.2 years. Thirty-three patients were previously healthy whereas eight patients had coexisting comorbidities,” said Dr Mahesh K, professor, Department of Paediatric Cardiology.
The study revealed that fever, fatigue, abdominal pain, diarrhoea and loss of appetite were the common symptoms among children. The second most common occurrence was mucocutaneous involvement which was present in 88 per cent of cases.
“The most common mucocutaneous involvement— inflammation of the mucus membrane— was conjunctivitis in 71 per cent patients. Oropharyngeal changes including red lips/red tongue or cheilitis were present in 49 per cent of the cases. Cardiovascular system was involved in 54 per cent cases clinically. Neurological symptoms were present in 51 per cent of cases and meningismus in 15 per cent of cases. 46 per cent of cases had either irritability, somnolence, or altered mental status,” said Dr Suchitra Sivadas, Assistant Professor, Department of General Paediatrics, Amrita Hospital.
A total of 36 patients or 88 per cent cases required intensive care, while ventilator support was required in 20 per cent cases and immunomodulatory therapy was administered to 95 per cent cases. Two patients died during treatment of the acute phase. “The discharged patients were followed up for six to 12 weeks for reporting medium-term results,” said Dr Sajith Kesavan, senior consultant and head, Paediatric Pulmonary and Critical Care.