The curious case of MIS-C, a disease associated with Covid-19, affecting children

CHENNAI: Raksha* is the only patient among over 100 children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C), a disease associated with Covid-19, at the Government Institute of Child Health in Chennai's Egmore, to have spent nearly three months in the Intensive Care Unit with ventilation support.

The eight-year-old girl from Alwarthiru Nagar in the city was wheeled into the hospital on July 21 from a private hospital with a history of fever, cold, abdomen pain, breathlessness, and other complaints. "The child was very sick; she came to the hospital with ventilator support, intubated. Immediately, we shifted her to the ICU and started emergency care, " said Dr S Elilarasi, Director of the Institute of Child Health.

MIS-C, a rare but serious disease was first recognised in the UK in 2020 in children who recovered from Covid-19. It leaves all the organs, including heart, kidneys, brain, skin, eyes and other parts inflamed. Interestingly, Raksha's parents had no clue that she was infected with Covid-19 in the past, said the doctors.

"When we recognised all her symptoms of MIS-C, we tested her for Covid antibodies and found IgG which confirmed her past Covid-19 infection. Then, we put her on steroids and immunoglobulin along with supportive care. But she was in the ICU for 90 days with ventilation support," said Dr Poovazhagi, professor of Paediatric Intensive Care at the hospital.

Only 30 to 40 per cent of the child's lungs were functioning. She also had a severe cardiac problem, and had developed sepsis, said doctors. "All the specialists, including cardiologist, pulmonologist, and vascular surgeons were called in to treat and save her," said Elilarasi.

"Many of the children admitted in the hospital didn't require much care, and had only mild symptoms. In some children, two or more organs were affected. Even they required only minimal oxygen support, but for the first time we saw a child whose organs were affected, and required oxygen support, until three days before her discharge," said Poovazhagi. The child was discharged from the hospital on October 18.

The hospital, which has treated over 100 children with MIS-C since June 2020, is now conducting a study on the disease to know more about it and to assess its manifestation in different children. "In our study, we want to follow up on children for at least for one and half years and see if they have any long-term effects," she said, adding all the treated children were recruited for the study. "It has been over a year since our first case, but we haven't seen any children with problems post discharge," said Poovazhagi.

The hospital has treated over 1,500 children with Covid-19 since the onset of the pandemic.

*Name changed