Post-Covid inflammatory syndrome on the rise among kids

Cases of a rare inflammatory syndrome among children who recently recovered from Covid-19, which had been seen last year, have made a comeback in the second wave, doctors said.

Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare complication of novel coronavirus infection, characterised by fever, inflammation, and multi-organ dysfunction that typically manifests two weeks after the child has been cured of Covid-19.

The exact data about how many children in Karnataka are affected is unknown.

However, doctors believe that the condition affects some 5% of Covid-recovered children.

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With Karnataka having seen 48,910 new child Covid cases since the start of the second wave on March 12 (including 812 new cases on Saturday), the potential number of sufferers could be sizable.

Several major hospitals in the city reported treating between 10 and two dozen cases over the last 15 days.

Well-known virologist Dr V Ravi, formerly of Nimhans, said the cases should refocus attention on child health and the fact that even children who have been cured of Covid-19 do not escape further complications.

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At Aster Hospitals, 12 new cases were reported over the last 15 days, according to Dr Sagar Bhattad, consultant, Paediatric Immunology and Rheumatology, Aster CMI Hospital.

“Many hospitals in the city are also witnessing similar numbers of cases. In fact, this disease is being noted in tier-two cities across the state,” Dr Bhattad said, adding that MIS-C is an immune-mediated disease secondary to Covid-19 and that it does not spread unless the child is or was suffering from the novel coronavirus.

The problem may not be acute in Bengaluru because many paediatricians are now aware of the syndrome unlike last year, said Dr Jagadish Chinappa, a paediatrician at Manipal Hospital and a member of the Third Wave Advisory Committee. “But delays in seeking medical care can be serious,” he said.

According to Dr Bhattad “If treated in time, its fatality is less than 2%.”

However, identifying MIS-C cases is problematic as its symptoms mimic other illnesses, said Dr Sridhar M, a Pediatric Intensivist at Rainbow Pediatric Hospital, where some 15 cases have been treated since the start of the second wave.

MIS-C’s symptoms of fever lasting for over 48 hours, diarrhoea, lymph node swelling of the neck, skin peeling, red eyes, stomach pains, rapid breathing and fatigue can be confused for other ailments.

Misdiagnosis in rural areas where the number of paediatricians is generally low is problematic.

As per data from the Indian Academy of Pediatrics (IAP), 57% of 2,958 paediatricians in Karnataka are concentrated in Bengaluru, Mysuru and Dakshina Kannada.

“Children who recently recovered from Covid-19 and show these symptoms must be presented to paediatricians. The problem generally affects children aged between 5 and 17,” Dr Chinappa said.