The Rising Cases of Multisystem Inflammatory Syndrome in Children After COVID Infection

 

Is it or was it COVID? That is the question doctors and parents are asking as the number of children admitted to the hospital for a rare pediatric inflammatory syndrome increases.

The Montreal Gazette recently published an article describing symptoms that caused twelve-year-old Rebecca Marchand to spend two days in intensive care and a total of five weeks in Montreal’s Children’s Hospital.

Common Symptoms for a Rare Disease

Rebecca’s mother Stephanie Peillon, told the Gazette that Rebecca began to have neck pain and headaches in March of this year followed by back pain. With each new symptom, her family had plausible explanations for what they thought were common occurrences.

It was not until Rebecca developed rashes and a high fever that her mother realized this was not an ordinary occurrence and rushed her to the ER.

Her doctors believe that her illness could be multisystem inflammatory syndrome in children (MIS-C), or as it is called in Canada and the UK, pediatric inflammatory multisystem syndrome in children (PIMS-C). The disease, a post-COVID-19 syndrome, is rare, but cases have been on the rise in Montreal. In one hospital the number of confirmed cases had been 30 to 40 patients per year but this year over 50 cases have been reported in the past ten months.

Adding to the mystery of Rebecca’s illness, although the disease is considered post-COVID, neither Rebecca nor her family had tested positive for COVID.

Rebecca, who had to remain in the hospital for five weeks, was recently discharged. She will continue corticosteroids (steroid hormones) and antibiotics for a while longer.

The First Signs of MIS-C

Doctors began to notice a few cases of MIS-C shortly after the initial spread of COVID-19 but at that time the disease was extremely rare.

MIS-C is still rare, yet the number of cases is slowly increasing as the pandemic moves into its second year. Doctors expect a third wave of the virus as it spreads among schools and daycare centers.

MIS-C Symptoms

Symptoms may include:

  • Severe abdominal pain
  • Fever that is ongoing
  • Redness in patients eyes
  • Rash

Severe cases may involve inflammation in the heart and other organs.

Marie-Paule Morin, M.D. is a rheumatologist specializing in pediatrics at the Hospital Ste-Justine in Montreal. Dr. Morin explains that a four to five-week period after a spike in COVID is generally followed by an increase in hospitalizations.

Dr. Morin noted that some children have had Kawasaki-like symptoms while others have presented with toxic shock symptoms. Kawasaki disorder is a rare illness leading to inflammation and swollen blood vessels.

The diagnosis thus far has only required an “association” with COVID-19 rather than actual proof via testing or being in close contact with COVID-19.

Dr. Morin offered her opinion that MIS-C is possibly the result of an overactive immune system, but this theory has not yet been confirmed.

A second pediatric rheumatologist at the hospital, Dr. Rosie Scuccimarri, agreed that the Children’s Hospital has had an increase in children with Kawasaki-like symptoms. However, a link to COVID-19 in some of the cases has not yet been established.

Dr. Scuccimarri added that COVID-19 symptoms seem to be spreading to young school children.

Testing Children for COVID-19

In order to test children who have symptoms of COVID-19, doctors will check for previous positive testing and whether anyone in the family had been infected. Blood tests can be administered to test for antibodies.

Yet the doctors are aware that at times, making that connection to COVID-19 may not be possible. Rebecca, her mother, and her sister were tested. No one tested positive.  Rebecca’s sister, however, presented with “COVID toes” that were purple and swollen.

Rebecca’s mother has online support with other parents. In addition to support, these parents share their experiences. The information is helpful as the children recover.

Her mother emphasized that parents must be on the alert for symptoms. She said that had she known about the similarity in symptoms she would have acted much sooner.

Rose Duesterwald

Rose Duesterwald

Rose became acquainted with Patient Worthy after her husband was diagnosed with Acute Myeloid Leukemia four years ago. He was treated with a methylating agent While he was being treated with a hypomethylating agent, Rose researched investigational drugs being developed to treat relapsed/refractory AML.

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