Early diagnosis of multisystem inflammatory syndrome in kids can reduce morbidity, say experts

NEW DELHI: Early diagnosis of Multisystem inflammatory syndrome, a coronavirus-linked disease, in children can significantly reduce morbidity, say healthcare experts as they advise parents and caregivers not to take fever among the kids lightly.

Experts say some children with asymptomatic or mild COVID-19 have also developed this disease.

Multisystem inflammatory syndrome in children (MIS-C) is a serious condition that is usually seen two to four weeks after getting infected by the novel coronavirus infection and infants as young as two months old have reported this disease.

The government has also cautioned that even though COVID-19 has not taken a serious shape among children till now, its impact can increase among them if there is a change in virus behaviour or epidemiology dynamics, and steps are being taken to strengthen preparedness to deal with any such situation.

A national expert group has been formed to review COVID-19 infections in children and approach the pandemic in a renewed way so as to strengthen the nation's preparedness, NITI Aayog Member (Health) V K Paul had said at a press conference last week.

According to the experts, early diagnosis of Multisystem inflammatory syndrome in children can significantly reduce morbidity and the condition can be treated well with therapies like steroids.

They also advise parents and caregivers to not take fever in their children lightly as some children who had asymptomatic COVID-19 have also developed MIS-C.

Anurag Agarwal, Professor, Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital says most children who become infected by COVID-19 have only mild illness, but in children who go on to develop MIS-C, some organs and tissues such as the heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes, become severely inflamed.

"Any child presenting with three days of fever with signs of at least two organ involvement, for instance, diarrhea, vomiting, breathlessness, fatigue, rashes, conjunctivitis etc, with the history of Covid infection or contact to Covid patient, should report to a doctor immediately for further evaluation.

"The disease can present with varying severity from mild forms to life-threatening disease. The illness, if diagnosed on time, responds to therapy like steroids, IVIG (Intravenous immunoglobulin), low molecular weight heparin, among others, very well," he says.

Noting that most major hospitals of Delhi have reported such cases with varying severity, Agarwal says till date mortality has been less in such cases with some patients requiring intensive care and monitoring.

"At present, social distancing and using masks to avoid Covid infections are the only way of preventing the development of this syndrome," he adds.

Manish Mannan, HOD, Paediatrics & Neonatology, Paras Hospitals Gurugram says it is crucial for parents to identify the problem early.

"So if anybody is having high grade fever, they should consult the pediatrician early, preferably on the first or second day. If we diagnose the disease early and intervene early, the treatment needed is less. And the morbidity is also less. The longer you wait, the greater the morbidity," he says.

Mannan also says that there have been instances of children, who were asymptomatic or had mild COVID-19, developing MIS-C.

"I have seen so many households wherein the parents have got their tests done, but they left out the child thinking he had mild or no COVID symptoms.

The child, however, developed MIS-C in three to four weeks," he says.

The official says it was recently seen that parents of two children who were admitted in the hospital had no clue when their kids were infected.

"But they both had significant symptoms of MIS-C and had to be admitted and treated.

Most of the cases of MIS-C can lead to hospital admission so parents should immediately get any fever of their child checked.

"So every fever in today's time should be suspected, unless proven otherwise, as prevention is better than cure," he adds.

Sudip Chowdhury, consultant paediatrician, Columbia Asia Hospital, Palam Vihar, Gurgaon also says that MIS-C is on the rise among children.

"In the last five days, over 100 cases of multi-organ inflammatory syndrome in children were reported in northern India, of which, more than 50 cases were found in the NCR," he says.

It has also been seen that younger patients have more severe forms of illness as compared to the ones in the first wave of COVID-19, he adds.