The inflammatory condition that affects children during the pandemic has been linked to infection with the coronavirus, a peer-reviewed study confirms.
Researchers at King’s College London have discovered that the disease, known as multisystem inflammatory syndrome in children (MIS-C), is different from Kawasaki disease.
The disease can manifest itself as a rash, fever and abdominal pain and is linked to previous infection with the same virus, SARS-CoV-2, which causes COVID-19.
COVID-19 has so far killed nearly three-quarters of a million people worldwide.
Scientists cannot explain why adults tend to develop COVID-19, while children are more likely to strike with MIS-C, despite being caused by the same virus.
The hyper-inflammatory condition is thought to be a delayed immune response to the infection, thereby improving traditional throat and nose swabs.
But more than two-thirds (68 percent) of children in the latest study tested positive for SARS-CoV-2 antibodies, proving that they had been infected in the past.
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Bertie Brown was admitted to Worcestershire Royal Hospital on his second birthday earlier this year after developing a fever and rash on his body, which is thought to have been MIS-C
MIS-C is a form of toxic shock syndrome that attacks the body’s immune system’s own organs. It is believed to be caused by infection with the coronavirus SARS-CoV-2
As the world wrestled with the COVID-19 pandemic, the Kawasaki-like state emerged and grew in frequency.
It almost exclusively affects children as young adults, in contrast to COVID-19 which rarely harms the young.
Despite the suspected association with the coronavirus and the similarity with the disease Kawasaki, scientists had not previously discovered what causes the disease and, in fact, what the disease is exactly.
But researchers have now published the first study confirming that MIS-C is its own unique condition associated with previous SARS-CoV-2 infection.
Topical treatments seem to be effective and include steroids, anticoagulants, immunoglobulin and, sometimes, ventilation and admission in intensive care.
However, the symptoms of the two conditions are very similar.
Dr Manu Shankar-Hari, co-author of the latest study, told MailOnline: ‘There is no diagnostic test for Kawasaki disease like MIS-C.
There are shared clinical features. So the best thing to do is seek medical advice, if your child is not well. ‘
MailOnline reported in May that researchers at Birmingham had reached the same conclusion, but their study had yet to be peer-reviewed, where it is being investigated by independent academics.
However, King’s College research has overcome such barriers, after they were published online in July as a pre-print. It is now available in Nature Medicine.
Dr Shankar-Hari, co-author of the latest study, told MailOnline: ‘This study highlights that, unlike Kawasaki disease, MIS-C is associated with SARS-CoV-2 infection with various clinical and immune findings.’
Chloe Knight, 22, revealed her two-year-old son, Freddie Merrylees (pictured), became ill just before the lockdown and was “like a zombie” because of the disease. The boy had a rash on his body, a high temperature, red eyes and had difficulty eating and drinking.
Children with the disease are normally brought to the hospital with a high fever that has lasted for several days and severe abdominal pain. The most severely ill can develop sepsis-like symptoms such as rapid breathing and poor blood circulation.
The study looked at the immune response in 25 children (15 boys and 10 girls) with MIS-C, aged 7-14 years, who were treated at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London.
All children had symptoms that doctors suspected led to MIS-C. Eighteen had reported gastrointestinal problems and seven showed signs of pneumonia.
The patients received antibody tests to see if they had been previously infected with SARS-CoV-2. Seventeen returned positive (68 percent).
While eight negative tests for antibodies, clinicians believe they may have sought contact with SARS-CoV-2 at some point.
This is because, of these eight, six had previously shown symptoms of SARS-CoV-2 infection, had been in close contact with people with confirmed cases of COVID-19 or had a parent who was a healthcare professional.
The patients were studied in three stages: first three days after admission to the hospital, as their symptoms improved and at their first outpatient appointment.
Blood samples and other tests were compared with seven children who were the same age and not bad.
What the researchers discovered is that the MIS-C condition causes the body to produce fewer B and T cells – which are part of the body’s immune response and help to suppress disease. This decline is reflected in adults with COVID-19.
However, the immune response was very different for Kawasaki disease.
‘Overall, MIS-C presents as an immunopathogenic disease and appears different from Kawasaki’s disease,’ the researchers write in the study.
Dr Shankar-Hari says it is difficult to quantify how common MIS-C is when the prevalence of SARS-CoV-2 in children remains a mystery.
Little is known about MIS-C, except that it is rare, caused by SARS-CoV-2 and has symptoms similar, but not identical, to Kawasaki disease.
It appeared earlier this year with parents sharing heartbreaking images of their children in the hospital covered in bright red rashes.
In May, at the height of the COVID-19 outbreak, doctors in the United States said the inflammatory condition could affect adults in their early 20s.
Although deaths from MIS-C are very rare, they have been recorded. A 14-year-old boy in London died of the disease. and at least four reported deaths in the U.S.
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