Multisystem Inflammatory Syndrome in Children in COVID-19 Pandemic
- PDF / 130,522 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 99 Downloads / 169 Views
COMMENTARY
Multisystem Inflammatory Syndrome in Children in COVID-19 Pandemic Satish K. Shah 1 & Alvaro Coronado Munoz 1 Received: 19 June 2020 / Accepted: 25 June 2020 # Dr. K C Chaudhuri Foundation 2020
The Multisystem System Inflammatory Syndrome in Children (MIS-C) has recently been described during COVID-19 pandemic. It has gained considerable interest for few reasons. First, it tends to manifest later in the course of SARS-CoV-2 infection and presents with higher severity. Second, even though it shares clinical and laboratory features of Kawasaki disease and Kawasaki-shock syndrome, the demographic and inflammatory process are different from the classical description. The case reported in this issue of Indian Journal of Pediatrics by Rauf et al. [1] describes the classical presentation of MIS-C which shares features similar to Kawasaki Disease. The authors report a 5-y-old boy from a COVID-19 hotspot area in India who presented with high grade fever, abdominal pain, diarrhea, bulbar conjunctivitis, edema and shock. Patient had increased C-reactive protein (CRP), ESR and ferritin suggesting a hyperinflammatory state. An elevated pro-BNP suggested acute heart failure confirmed by left ventricular hypokinesia and depressed left ventricular function on echocardiogram. An elevated Troponin-I indicated myocardial injury; however, the patient was not found to have coronary artery enlargement. Patient was managed with Intravenous Immunoglobin (IVIg) and pulse dose methyl prednisolone. Adrenaline was used for hypotension while diuretics and afterload reduction were used for acute heart failure. A repeat echocardiogram showed improved biventricular function. On day six of hospital stay, the patient was able to be discharged home with low dose aspirin, steroid and enalapril. Patient had initially tested negative for SARS-CoV-2 by RT- PCR and
* Satish K. Shah [email protected] 1
Department of Pediatrics, Pediatric Critical Care Division, University of Texas- Health Science Center at Houston, Children’s Memorial Hermann Hospital, Houston, TX 77030, USA
antibody testing was unavailable. However, there was history of possible COVID exposure in patient’s father. In the global pandemic setting of COVID-19, there are relatively fewer cases of COVID-19 children compared to adults. Children tend to have milder clinical course. Several reports published from different parts of the world have confirmed that severe illness and death due to COVID-19 in children is rare and is much less compared to adults [2–6]. However, in last 6 wk, especially at the end of peak number of cases in the developed world, pediatricians have started seeing multisystem inflammatory disorder similar to Kawasaki disease or Toxic Shock syndrome [7–9]. Children presented in critical conditions with heterogeneous inflammatory involvement. Various reports from many countries of children with fever and inflammation without obvious cause in the time of COVID-19 pandemic hints toward possible link between SARS-CoV-2 and this clinical syndrome. With t
Data Loading...
