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Published on January 26, 2021

little girl wearing mask

What is MIS-C? Understanding this Serious Condition in Children

A serious-but-thankfully rare condition kids exposed to COVID-19 can get has been in the news. Avera pediatric intensivists have been taking care of patients under 18, some as young as 2, who show signs such as intense stomach pain, diarrhea, vomiting, rashes and fever.

The condition is called multisystem inflammatory syndrome in children (MIS-C) and while rare, it’s serious and requires immediate medical attention.

“We don’t want parents to be scared. But moms and dads should understand what it is, what to look for and realize any children who are exposed to COVID-19 can develop MIS-C,” said Kara Bruning, MD, Avera Medical Group pediatrician. Symptomatic kids with COVID have coughs, fever and upset stomach for two or three days, and they get better. This is totally different.”

What Makes MIS-C a Unique Threat

When kids who contract MIS-C get sick – there’s no mistaking it as a mild illness. Symptoms include:

  • High fever
  • Intense stomach pain, along with vomiting and diarrhea
  • Widespread rash
  • Bloodshot eyes and crust forming on the eyelids
  • Bright red tongue and chapped lips

“MIS-C may not show up with the typical COVID-like symptoms, and some kids may have no respiratory problems, coughing or breathing difficulty at all,” said Kingshuk Dasgupta, MD, Avera Medical Group pediatric intensivist. “We had a case where the pain was so intense, we performed surgery to rule out an appendicitis. The pain was that intense.”

He said the inflammation will spread to vital organs and can affect the heart, blood vessels and kidneys. “Patients frequently develop shock and low blood pressure,” Dasgupta said.

Most MIS-C patients are 21 or younger. Dasgupta said the patients he’s treated were mostly between ages 5 and 11, but a few between ages 2 and 3. Not every child will show each and every symptom.

Another Syndrome Guided MIS-C Treatment

Treatments can help kids – but a quick response is vital. The timely use of intravenous medications can lessen the impacts.

“A combination of IV immunoglobulin treatments and IV steroids helps to manage the inflammation,” Dasgupta said.

“Kids who have this will be super-sick, and we encourage parents to call their provider, go to urgent care or an emergency room right away,” Bruning said. “If you’re concerned – call us.”

Most children will be admitted and many need intensive care. Care providers treat the condition and closely monitor young patients for other problems.

Physicians and researchers, including Dasgupta, drew parallels in treatment between this new COVID-related condition and one known as Kawasaki syndrome. By applying the treatments that help fight Kawasaki syndrome, which was discovered in the 1960s, care professionals found successes.

“This new condition mimics many of the Kawasaki symptoms, so we approached it with treatments that have been studied and proven to work with that,” Dasgupta said. “When we use that first line of treatment – IV immunoglobulin and steroids – we’ve had success. There are additional medications that would be a second level of treatment, but thankfully, we haven’t had to use them.”

Recovering Patients and Long-Term Effects

Since the syndrome has only developed in the months since the pandemic began, the long-term effects it might have on young bodies are uncertain.

“We can treat it initially and then make sure that we continue to do tests and treatments as they are needed,” Bruning said. “We remind parents to not hesitate if your child is facing this condition.”

You can talk to your family doctor or your pediatrician about this condition. Wearing masks, social distancing, handwashing and other measures also can help your kids avoid exposure to COVID-19. Vaccines are now recommended for everyone 5 and older.

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