Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but serious condition that can affect children and adolescents. This syndrome involves inflammation across different body systems and organs. It can lead to complications if not identified and addressed promptly.
What is MIS-C and Its Connection to COVID-19
MIS-C is a condition where various body parts, including the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal organs, can become inflamed. This syndrome is a delayed, post-infectious complication strongly linked to SARS-CoV-2, the virus responsible for COVID-19. It typically develops several weeks, often within two months, after a child has been infected with the COVID-19 virus. Even if the initial COVID-19 infection was mild or asymptomatic, a child can still develop MIS-C.
Researchers are still studying the exact cause, but it is thought to involve an overreaction of the child’s immune system following the viral infection, leading to widespread inflammation that can damage organs. While MIS-C can affect children of all ages and ethnicities, it has been observed more commonly in school-aged children and adolescents.
Recognizing the Symptoms of MIS-C
A persistent fever, lasting at least 24 hours or even three or more days, is a common symptom. Children may also experience gastrointestinal issues such as abdominal pain, vomiting, or diarrhea. These abdominal symptoms can sometimes be severe and resemble appendicitis.
Other potential signs include a skin rash, bloodshot eyes, and swollen or red hands and feet. Some children might also have inflamed mucous membranes in the mouth, cracked lips, or a swollen tongue that appears like a strawberry. Feeling unusually tired, lightheaded, or dizzy are additional symptoms that parents should observe.
Symptoms that suggest a more urgent situation include signs of shock or heart problems, such as cold, clammy skin, very low blood pressure, difficulty breathing, or severe shortness of breath. A very high heart rate or an irregular heartbeat should also prompt immediate concern. If a child exhibits alarming or unexplained symptoms, even with only a day of fever, contact a healthcare provider.
How MIS-C is Diagnosed and Treated
Doctors typically begin with a physical examination and assess the child’s symptoms. Blood tests are standard, looking for markers of inflammation throughout the body to determine the extent of the inflammatory response. In addition to blood tests, imaging studies may be used to check for organ involvement.
An echocardiogram, an ultrasound of the heart, is often performed to evaluate heart function. Other tests, such as an abdominal ultrasound or a chest X-ray, might also be conducted to assess other organs. A positive test for COVID-19 (recent or current) or evidence of antibodies to the virus is also part of the diagnostic criteria.
Treatment for MIS-C typically occurs in a hospital setting, sometimes in a pediatric intensive care unit (PICU) for more severe cases. The general approach focuses on supportive care and reducing inflammation. Medications like corticosteroids are often administered to suppress the immune system’s inflammatory response. Intravenous immunoglobulin (IVIG), a product made from human plasma containing antibodies, is another common treatment used to help regulate the immune system.
Recovery and When to Seek Medical Attention
Most children who develop MIS-C recover with appropriate medical care and careful observation. The recovery period can vary, potentially taking between three days and two weeks for a child to feel better after treatment begins. Follow-up care is important to monitor the child’s recovery and address any potential lingering effects on affected organs, particularly the heart.
Despite the generally positive prognosis, certain urgent warning signs indicate the need for immediate medical attention. If a child experiences trouble breathing, severe chest pain or pressure, or new confusion, emergency care should be sought without delay. Other severe signs include the inability to wake up or stay awake, bluish lips or face, or severe abdominal pain. Parents should trust their instincts and seek help immediately if their child exhibits any of these concerning symptoms.