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Multisystem inflammatory syndrome spike seen in Memphis children

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Multisystem inflammatory syndrome spike seen in Memphis children

Le Bonheur Children’s Hospital has seen an influx of children with multisystem inflammatory syndrome, a COVID-19 complication, likely as a result of the spike of infections in Shelby County in July. 

The rare inflammatory syndrome, known as MIS-C, was identified among children in New York hospitals in the spring and has been tracked by the Centers for Disease Control and Prevention across the country since May. Symptoms initially stumped doctors, and some speculated early on in the pandemic that children were experiencing another rare inflammatory syndrome called Kawasaki disease. 

In Shelby County, Le Bonheur said it has seen a total of 25 cases of MIS-C throughout the pandemic, with most of those cases being treated recently. The syndrome is a complication of a COVID-19 infection that occurs weeks after the initial infection. 

Nicholas Hysmith, medical director of infection prevention at the hospital, pointed to the spike of COVID-19 cases in July as the reason for more children being treated for MIS-C now. 

“This is all a result of kids who were probably infected during that peak time that we saw, and whether or not they had symptoms or not, it doesn’t seem to really matter,” he said. 

Children who have MIS-C test positive for antibodies of COVID-19, indicating that they did have the virus previously. While some of the patients did have mild symptoms with the initial COVID-19 infection, others with MIS-C never had symptoms or known exposure, Hysmith said, meaning they likely had an asymptomatic infection of COVID-19. 

So far, the patients at Le Bonheur with MIS-C have made full recoveries and there have been no deaths reported from patients with the inflammatory syndrome, Hysmith said. Patients with MIS-C are staying in the hospital for two weeks or more, which is longer than the one-week stay most have for Kawasaki, he said.

Most children in the intensive care unit with COVID-19 complications are those who have MIS-C rather than medical problems directly related to a new infection, Hysmith said. Of the MIS-C cases at Le Bonheur, he said about one-third of those children have needed ICU attention, usually for cardiac dysfunction and low blood pressure.

The inflammatory disease occurs when an immune response continues on for longer than it should after a COVID-19 infection and affects multiple systems of the body. The threat to the heart, though, is not as severe as what is caused by Kawasaki disease, Hysmith said. 

Most of the MIS-C cases, Hysmith said, are identified after a child has a fever for a prolonged period, somewhere around 5-7 days. Along with prolonged fever, abdominal pain, diarrhea, nausea and vomiting have been the most common signs and symptoms of MIS-C, identified by the hospital. Children may also have dry cough and trouble breathing, rash or eye redness, as well as more specific signs and symptoms like a red tongue (known as “strawberry tongue”) or chapped lips, swollen hands or feet, or signs of shock, to include fast heartbeat, low blood pressure or confusion. 

Children’s signs and symptoms resolve through the duration of their hospital stays, Hysmith said. So far, there is not indication children would face any prolonged health issues from MIS-C, he said, with the caveat that there is still more to learn about MIS-C.

Having another underlying medical condition does not seem to be a predictor for developing MIS-C, Hysmith said.

So long as students are practicing infection prevention — wearing masks, socially distancing, washing hands — parents should not be afraid to send them back to school for fear of developing MIS-C as a COVID-19 complication, he said. 

“Unfortunately (MIS-C) is just a rare event that seems to be happening in some kids a few weeks after getting a (COVID-19) infection, and hopefully as time goes on and we get more literature and more information, we’ll have a better idea of exactly what is causing that hyper inflammation,” he said. “But I don’t think that parents should be afraid to send their children to school. They shouldn’t be afraid of MIS-C as a reason…to not send their kids to school.”

More: Report cases of COVID-19 in Memphis schools and universities to The Commercial Appeal

Laura Testino covers education and children’s issues for the Commercial Appeal. Reach her at laura.testino@commercialappeal.com or 901-512-3763. Find her on Twitter: @LDTestino

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