Multisystem inflammatory syndrome in children (MIS-C) is the latest mystery to come from the coronavirus pandemic. It has been likened to Kawasaki disease, it's landing children in the ER and hospital, and doctors are still trying to unravel exactly how it affects kids' bodies. MIS-C is on every parent's radar now, but it's hard to understand exactly what it is, why it happens and what to watch for.
Michael Gayle, MD, chief of Pediatric Critical Care at Wolfson Children's Hospital, wants parents to know that this condition is rare. Even though it's all over the news right now, it's highly unlikely to affect your child.
"The first thing folks ought to know is this is a very rare condition associated with COVID-19 in children, and the survival rate is very high," Dr. Gayle said. "So far in the U.S., there have been more than 400 cases identified but this number will likely increase. When it comes to COVID-19 cases in children in the U.S., we've had thousands, so the number of MIS-C cases is low."
If you're concerned your child has been exposed to COVID-19, be on the lookout for the following symptoms of MIS-C:
- Abdominal pain
- Bloodshot eyes
- Generalized skin rash, including on the lips, hands and feet
- Signs of shock, including rapid breathing or heart rate, low blood pressure and change in mental status
- Very high fever of 101 degrees or higher
- Vomiting or diarrhea
"A typical MIS-C patient will usually present with a very high fever, abdominal pain and may be in a shock-like state, which COVID-19 doesn't present with," he explained.
MIS-C develops after a child has been exposed to the coronavirus and has had time to develop antibodies against it. So, even if they show no signs of the virus initially, this associated condition can appear a few weeks after they were first infected.
"When a series of MIS-C patients in New York were given the COVID-19 antibody test, about 87% of them tested positive," said Dr. Gayle. "To be diagnosed with MIS-C, a patient would have to exhibit some of the symptoms and have a positive viral test for COVID-19, a positive antibody test for COVID-19, or a link to a known COVID-19 case."
Also, while early news coverage of MIS-C likened it to Kawasaki disease, they're not the same thing. Like MIS-C, Kawasaki disease causes things like rash, bloodshot eyes and vomiting, but only MIS-C is associated with COVID-19 exposure.
While COVID-19 affects the elderly and those with weaker immune systems at higher rates, MIS-C can affect any child, even one who is totally healthy otherwise.
"No risk factors have been established," Dr. Gayle said. "With this condition, most of the children will be between 4 and 15 years old, with most having no preexisting conditions. These are usually normal, previously healthy kids."
If your child is exhibiting signs of MIS-C, call your pediatrician right away. If your child is severely ill, take him to a Wolfson Children's emergency room immediately.
"Wolfson Children's is specially prepared to handle this condition since it can affect multiple systems of the body and require a team of pediatric expert physicians to treat your child," Dr. Gayle said.