Inflammatory Syndrome in Children

Cases of this severe disease in children are very low in omicron times

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MIS-C COVID

Overall cases in children this year, 4.6 million

Multisystem Inflammatory Syndrome


What is MIS?

MIS is a rare but serious condition associated with COVID-19 in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

https://amp.cnn.com/cnn/2022/02/22/health/mis-c-omicron-waiting-for-trouble/index.html

https://covid.cdc.gov/covid-data-tracker/#mis-national-surveillance

Total MIS-C cases, 6,851

Deaths, 59

Child cases, 12.5 million since start of pandemic

Children, 0.00%-0.25% of all COVID-19 deaths

https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/


The median age 9 years

Half of children with MIS-C were between the ages of 5 and 13 years.

60% of reported patients were male.

59% of the reported patients Hispanic/Latino or black

Black, 2,050

Hispanic/Latino, 1,746

98% of patients had a positive test result for SARS CoV-2

2% of patients had contact with someone with COVID-19

MIS-C can occur weeks after COVID-19 and even if the child or family did not know the child had COVID-19.

Clinical Criteria

Fever, ≥38.0 C) for ≥24 hours

Shock or hypotension

Severe cardiac illness

myocarditis, pericarditis, coronary artery dilatation/aneurysm
new-onset right or left ventricular dysfunction
2nd/3rd degree A-V block
ventricular tachycardia

Rash AND non-purulent conjunctivitis

New-onset neurologic signs and symptoms

Encephalopathy, seizures, meningeal signs, or peripheral neuropathy (including Guillain-BarrĂ© syndrome)

Abdominal pain, vomiting, or diarrhea

Thrombocytopenia

Elevated inflammatory markers

A positive SARS-CoV-2 test for current or recent infection by RT-PCR, serology, or antigen detection

Dr. Roberta DeBiasi, Infectious Disease Division chief at Children's National Hospital, Washington, DC

It always follows the same pattern

It's always two to six weeks after we see the spike from whatever variant it is,

and then we're on the lookout for MIS-C. And then, sure enough, it comes."

some of the MIS-C patients have been vaccinated, but the vast majority are not

we thought we may see an uptick with Omicron, but we haven't.

University of Pittsburgh Medical Center, Dr. Marian Michaels

Luckily, in our area we are not seeing a surge

I'm very grateful

Seattle Children's Dr. Michael Portman, director of research in the Division of Cardiology

More MIS-C cases since mid-December 2021

https://www.ahajournals.org/doi/10.1161/JAHA.121.023251

most children with MIS-C begin recovering in the first week after hospital discharge and fully recover heart function within three months

Inflammatory Syndrome in Children

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