Multisystem Inflammatory Syndrome in Children | 27 Nov 2021

Why in News

Recently, the World Health Organization (WHO) has released fresh guidelines for treating children who developed Multisystem Inflammatory Syndrome (MIS-C) after being exposed to Covid-19 infection.

Key Points

• About:
  
  • MIS-C is a condition where various organs of the body are affected by inflammation. The patient develops heart problems, the severity of which may determine the line of treatment.
  • It is a rare but severe hyperinflammatory condition in children and adolescents that typically occurs 2-6 weeks after a Covid-19 infection.
  • It is a potentially deadly condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.
  • Children with MIS-C may have a fever and various symptoms, including abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired.
• MIS-C with Neurological Complications:
  
  • In a recent study, young people with the MIS-C syndrome have shown neurological issues which were life-threatening such as strokes or severe encephalopathy (any brain disease that alters brain function or structure).
  • Neurological symptoms include hallucinations, confusion, speech impairments, and problems with balance and coordination.
  • The new findings strengthen the theory that the syndrome is related to a surge of inflammation triggered by an immune response to the virus.
• Causes of MIS-C:
  
  • As the Syndrome is less researched, there are varied theories as to what causes MIS-C.
  • While some researchers believe that MIS-C is a delayed response to the coronavirus which in turn causes massive inflammation in the body and as a result damages organs.
  • Others believe that it can also be a result of the children’s immune response making antibodies against the virus.
  • There may be a genetic component as not every child develops MIS-C and the presenting symptoms are so varied.
• WHO Guidelines for Treatment:
  
  • It is suggested to use corticosteroids in addition to the standard of care for Kawasaki disease (conditional recommendation, very low certainty) in hospitalised children (0-18 years of age).
    
    • Commonly referred to as steroids, corticosteroids are a type of anti-inflammatory drug.
    • Corticosteroids along with supportive care resulted in a more effective treatment than either intravenous immunoglobulin plus supportive care or supportive care alone.
    • The treatment was also found to be effective in treating children with Kawasaki disease in association to Covid-19.
  • Not to use corticosteroids in the treatment of patients with non-severe Covid-19 as the treatment brought no benefits, and could even prove harmful.

Source: DTE