Multi-system Inflammatory Syndrome in Children Associated with COVID-19

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Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. While everything about the origins of the condition is still unclear, it has come to observation that many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19. MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care.

What are the symptoms of MIS-C?

Signs and symptoms of multisystem inflammatory syndrome in children (MIS-C) include those below, though not all children have the same symptoms.

• Fever that lasts 24 hours or longer
• Vomiting
• Diarrhea
• Pain in the stomach
• Skin rash
• Feeling unusually tired
• Fast heartbeat
• Rapid breathing
• Red eyes
• Redness or swelling of the lips and tongue
• Redness or swelling of the hands or feet
• Headache, dizziness or lightheadedness
• Enlarged lymph nodes

What are the emergency warning signs of MIS-C?

• Severe stomach pain
• Difficulty breathing
• Pale, gray or blue-colored skin, lips or nail beds — depending on skin tone
• New confusion
• Inability to wake up or stay awake

What should you know as parents?

• Children with acute COVID-19 can present with non-specific symptoms. Exclude COVID-19 in children with fever and respiratory tract symptoms or loss of taste or smell, especially if there is possible exposure to others with the virus

• Consider multisystem inflammatory syndrome in children presenting with fever and abdominal symptoms, especially if they develop conjunctivitis or rash, and refer to a pediatric emergency department for evaluation

• MIS-C can have overlapping symptomatology with disease processes that require prompt treatment, such as sepsis, toxic shock syndrome, myocarditis, and meningitis. Therefore, consider initiation of empiric antibiotics and necessary evaluations if the patient develops cardiovascular or respiratory compromise, evidence of acute abdomen, or meningismus

• Simple prevention measures, including mask wearing, hand hygiene, and social distancing remain crucial to prevent the spread of SARS-CoV-2 in children and adults

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