infections center

Can COVID-19 Cause Pediatric Multisystem Inflammatory Syndrome (PMIS) in Children?

The cause of MIS-C (multisystem inflammatory syndrome in children) is unknown but of the children who have developed MIS-C, many have had COVID-19 or been exposed to someone who has.
The cause of MIS-C (multisystem inflammatory syndrome in children) is unknown but of the children who have developed MIS-C, many have had COVID-19 or been exposed to someone who has.

Multisystem inflammatory syndrome in children (MIS-C) is a condition in which inflammation of different body parts such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs occurs.

Most children diagnosed with MIS-C will recover with medical care, but the condition can be serious, and in some cases, fatal.

  • The cause of MIS-C is unknown but it seems to be linked to the virus that causes COVID-19, as many children who have developed MIS-C have had COVID-19 or been exposed to someone who has.
  • Multisystem inflammatory syndrome in children commonly affects children about eight to nine years old, but it can affect infants and young adults. 
  • MIS-C is rare, and it is not entirely known how exactly the condition affects children and why some children develop MIS-C and others do not. 

What Are Symptoms of Pediatric Multisystem Inflammatory Syndrome (PMIS)?

Symptoms of pediatric multisystem inflammatory syndrome (MIS-C) usually occur between two and six weeks (with an average of four weeks) following infection with the virus that causes COVID-19.

Symptoms of pediatric multisystem inflammatory syndrome include:

Call 911 and get your child to a hospital’s emergency immediately if your child shows any of the following symptoms:

  • Difficulty breathing/shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake up or stay awake
  • Vomiting and not able to hold anything down
  • Fainting or passing out
  • Very rapid heart rate
  • Pale, gray, or blue-colored skin, lips, or nail beds

Notify the medical staff if your child has been diagnosed with COVID-19 or has been exposed to the virus. 

How Is Pediatric Multisystem Inflammatory Syndrome (PMIS) Diagnosed?

Pediatric multisystem inflammatory syndrome (MIS-C) is diagnosed with a patient history including questions about any recent diagnosis of COVID-19 or any known exposure to COVID-19, and a physical examination. 

Tests might include:

What Is the Treatment for Pediatric Multisystem Inflammatory Syndrome (PMIS)?

Pediatric multisystem inflammatory syndrome (MIS-C) usually requires treatment in the hospital, and in some cases, the pediatric intensive care unit (PICU). 

Treatment for MIS-C involves supportive care for symptoms and medicines to treat inflammation, such as: 

  • Intravenous (IV) fluids
  • Heart medicines
    • Digoxin 
    • Beta-blockers
    • Calcium channel blockers
    • Antiarrhythmic medicines 
  • Respiratory support
    • High-flow nasal oxygen  
    • Noninvasive ventilation
      • Positive airway pressure (CPAP or BiPAP)
    • Ventilator
  • Extracorporeal membranous oxygenation (ECMO) (used in rare, severe cases)
  • Anti-inflammatory treatments 
    • Intravenous immune globulin (IVIG)
    • Steroids
    • Non-steroidal anti-inflammatory medications
    • Low-dose aspirin may be used due to concerns for coronary artery involvement
  • Antibiotics to treat potential sepsis while awaiting bacterial cultures
  • Medicines to prevent blood clots are often used 

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References
https://www.cdc.gov/mis/mis-c.html

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/misc-and-covid19-rare-inflammatory-syndrome-in-kids-and-teens