KOCHI: With the second wave of Covid almost coming to an end, doctors have warned of an impending wave of Multisystem Inflammatory Syndrome or MIS-C across south India that may affect children more. The number of children coming to the hospital with MIS-C has increased and doctors believe this is just the beginning.
The disease mainly affects children exposed to Covid positive individuals, or those who have been infected themselves. The symptoms begin to manifest three to six weeks after a wave of Covid sweeps through the adult population, doctors said, adding that it is only a matter of time before the MIS-C wave will begin to take over the young population.
More than 50 per cent of those suffering from MIS-C develop heart problems. The severity of heart damage in patients is what determines the outcome of the illness. “MIS-C has been observed to correlate with the Covid wave in adults — the stronger the Covid wave, the bigger is the MIS-C backlash. Since the current Covid wave in South India has been the strongest so far, we are anticipating a huge MIS-C wave in the months to come. Symptoms of MIS-C include a rapidly progressing state of high-grade fever with poor functioning of several organ systems, especially the heart and gastrointestinal organs.
A child with MIS-C may have been completely asymptomatic if they had Covid previously and may not have been tested simply because they did not show symptoms. MIS-C starts to manifest within 4 to 6 weeks of having survived Covid,” said Dr Suma Balan, rheumatologist at Amrita Institute of Medical Sciences (AIMS), Kochi.The best way to tackle MIS-C is to prevent it. Ensuring vaccination of all adults in contact with children and through timely identification and treatment of the infection.
Treatment
MIS-C can be treated by administering steroids and intravenous immunoglobulin along with supportive management which requires intensive care in most cases.
Some children need breathing support and medications to support the failing heart. Because of the high cost of intravenous immunoglobulin, the treatment for MIS-C is expensive.
DOCS TALK
It is critical to identify the extent to which the heart is affected. In some cases, children may require pacemaker implantation to support heartbeat. The heart shows excellent recovery if supported well during the critical phase of the illness
Dr Mahesh Kappanayil, Clinical Professor, Department of Pediatric Cardiology, AIMS
When MIS-C affected children become so sick that they need intensive care, they also usually require IVIg treatment. Though expensive, this treatment can save a lot of lives. If a child is suspected to be suffering from MIS-C, a history of a possible Covid link must be explored
Dr Sajith Kesavan, Senior Consultant, AIMS
In MIS-C, different systems are involved, like the gastrointestinal tract, lung, kidney, and skin. During this Covid pandemic, irrespective of the fact that one has had Covid or not, if there is fever or other symptoms, medical care must be sought at the earliest. Please do not ignore symptoms of any disease in this season of the pandemic
Dr C Jayakumar, head deptof Pediatrics, AIMS
WHAT TO LOOK FOR?
Signs and symptoms of multisystem inflammatory syndrome in children (MIS-C) include fever that lasts 24 hours or longer, vomiting, diarrhea, pain in the stomach, skin rash, unusual tiredness, fast heartbeat, rapid breathing, red eyes, redness or swelling of the lips and tongue, redness or swelling of the hands or feet, headache, dizziness or lightheadedness and enlarged lymph nodes. Pale, gray or blue-colored skin, lips or nail beds can be considered an immediate sign.