MADURAI: With the State still grappling with mucormycosis, also known as black fungus infection, 11 children admitted to the Government Rajaji Hospital (GRH) have been diagnosed with another post-Covid condition, Multisystem Inflammatory Syndrome in Children (MIS-C) -- a condition that predominantly develops among children with a history of Covid-19 -- during the second wave of Covid-19. The steady rise in these post-Covid conditions also indicates the dire need for the revival of post-Covid clinics that have gone defunct.
In data obtained by TNIE, it was revealed that 37 children (aged below 13 years) with MIS-C have been treated at the GRH in the district during the two waves of Covid-19, with zero casualties. Sources said that the 11 children were treated at the hospital in the past two-and-a-half months, during the second wave of Covid-19.
Of the 37 children who got the treatment, 26 were treated till March 2021, while 11 children were treated from April (second wave). At present, four children are receiving treatment for MIS-C at the GRH. Head of Department of Paediatrics at GRH Dr S Balasankar said that as a measure to step up the preparedness for the third wave (that is predicted to affect children the most) and to handle any possible surge in MIS-C cases, arrangements are being made to set up a dedicated ward for children with 102 beds, including 30 ICU beds, in the ground floor of super speciality block of the hospital.
President of the Indian Academy of Paediatrics - Tamil Nadu State Chapter Dr Mohammed Ismail stated that a steady increase in the number of MIS-C cases were being reported across the State, during the second wave of Covid in comparison to the first wave.
He further said that children who develop MIS-C symptoms, including high fever for more than two days, conjunctivitis, skin rashes, Covid toes, abdominal pain, sudden dullness, breathlessness, require immediate medical attention. As MIS-C leads to multi-organ failure affecting the heart, lungs, liver and brain, early detection becomes crucial, he added.
He also stated that MIS-C cases that resemble Kawasaki disease in the symptoms are diagnosed clinically and through multiple techniques like renal, cardiac and liver screening, MRI scan. “While mildly and moderately affected MIS-C patients can be treated with steroids, severe cases require Intravenous Immunoglobulin (IV-IG). Administration of IV-IG has shown better results,” Dr Ismail mentioned.
At a time when the State simultaneously witnesses a decline in fresh Covid-19 cases and a steady increase in post-Covid complications such as mucormycosis and MIS-C, the post-Covid (outpatient) clinics that were opened at all government medical college hospitals during the last wave remain defunct. For instance, the dedicated post-covid clinic at the GRH now functions as the orthopaedic outpatient clinic. Hospital sources stated that patients with Covid history directly report to the concerned speciality departments and that there was a lukewarm response from the recovered patients to phone calls from hospital when they are asked to report to the hospital for a post-Covid check-up.
However, experts opine that there is an immediate need to revive dedicated post-Covid clinics to closely monitor the health complications that have emerged during the second wave that turned out to be deadlier and more challenging to the healthcare system.
Public health expert and member of the Tamil Nadu Covid Task Force Dr K Kolandaswamy emphasised that tele-counselling (through Covid control rooms) and decentralised post-Covid clinics (at PHCs, taluk hospitals and government medical college hospitals) must be strengthened in all districts to ramp up the vigil against serious post-Covid complications including the onset of diabetes, stroke, cardiac ailments.
Minister for Medical and Family Welfare Ma Subramanian said that steps would be taken to revive the post-Covid clinics by linking them to the district-level Covid War Rooms.
The Principal Secretary to the Department of Medical and Family Welfare Dr J Radhakrishnan said, “With fresh cases waning across the state, it is now time to revive the post-Covid clinics in all districts.”