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Endre Szvetnik By Endre Szvetnik • June 8, 2020

COVID-19 FAQ: what’s the strange syndrome in children that is linked to COVID-19?

Although children are far less likely to fall severely ill with COVID-19 than people over 60, cases of a mysterious inflammatory condition have been identified by doctors who suspect that it’s linked to SARS-CoV-2 infection.

The race is on to explain the strange, Kawasaki-disease-like syndrome in post-covid childen

The WHO and CDC call it multisystem inflammatory syndrome in children, or MIS-C. At the time of writing, around one thousand children were treated for MIS-C across the world, according to the WHO. Based on news reports, less than 10 children died from the condition. The syndrome resembles Kawasaki disease which has been linked previously byresearchers to respiratory viruses, including seasonal coronavirus. Kawasaki disease primarily affects children under the age of 5 and causes blood vessels to be inflamed and swollen, which in some cases can lead to heart complications. The reason doctors think the new syndrome, MIS-C, is linked to COVID-19 is that the majority of children who developed the symptoms either tested positive for COVID-19 or for antibodies suggesting they’ve had COVID-19 before. A French study found that, of 21 children observed with Kawasaki-like symptoms in a Paris hospital, 90% had evidence of recent SARS-CoV-2 infection. Experts believe MIS-C develops because the immune system goes into overdrive or is unable to reduce its response, producing high levels of inflammation.

What are the symptoms and what are the outcomes for children with MIS-C? A paper published at the end of May listed fever, diarrhoea, shock, and variable presence of rash, conjunctivitis, extremity oedema, and mucous membrane changes among the symptoms. The CDC added heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organ inflammation to the list.  A French study published in the American Heart Association journal, Circulation, reviewed the cases of thirty-five children with MIS-C. The majority had poor heart function and needed inotropic agents, a class of drugs that boost heart muscle contractions. 28% of them were put on ECMO machines that pump oxygen into the blood to allow the heart and lungs some rest. Heart complications in Kawasaki disease are normally treated with aspirin and antibodies acquired from donated blood, a treatment called immune globulin therapy. The Circulation study noted that the majority of children suffering from heart failure due to MIS-C were also given immune globulin treatment and have overwhelmingly recovered. At the moment this appears to be a very rare condition and so, evaluations of therapies and guidelines for diagnosing and treating the syndrome are still evolving. However, the advice is to take a child immediately to the hospital if they are showing MIS-C symptoms.

Here is the current state of science on a Sparrho pinboardNB: The pinboard contains research papers that have not been peer-reviewed yet, meaning that they have not gone through the standard scientific validation process yet.

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