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In the largest study of its kind to date, US researchers have analyzed the course of the disease in 577 children and adolescents with severe COVID-19 and 539 children and adolescents with a diagnosis of MIS-C.
The study is published in a prestigious JAMA journal.
The patients in the study population were all under 21 years of age. They were admitted to 66 different hospitals between March 15 and October 31, 2020 in 31 US states.
It is well known that children are significantly less likely to develop severe coronavirus disease than adults.
However, a high infection pressure means that more children and young people, in rare cases, will be affected by a potentially dangerous syndrome.
MIS-C can occur in children and adolescents after infection with the SARS-CoV-2 coronavirus.
Inflammatory disease
The abbreviation MIS-C is derived from the name of the disorder in English – “Multisystemic inflammatory syndrome in children”, which in Norwegian has been given the name “Multi-organ inflammatory syndrome in children”.
The disease is associated with an inflammatory condition in various organs such as the skin, mucous membranes, heart, lungs, gastrointestinal tract, as well as liver and kidneys after suffering from COVID-19 disease.
NEW SYNDROME: The rare childhood syndrome MIS-C has characteristics similar to childhood Kawasaki disease that can cause rashes, cataracts, mucosal changes, swollen lymph nodes, and skin changes on the palms and soles of the feet. The image is taken from a research report. In October of last year, MIS-C became a separate diagnosis. The condition is related to covid-19 infection. Photo: jaadcasereports.org
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It is no coincidence that the first large study on MIS-C came from the United States.
The country is very affected by the current corona pandemic with almost 30 million detected infected and more than 530,000 deaths registered by covid-19.
Updated figures from the CDC from the American Institute for Infection Control say that 2,060 children and youth so far during the pandemic have been affected by the inflammation syndrome. 30 have died as a result of MIS-C.
FHI has so far registered between five and ten cases in Norway.
Few deaths
Researchers have found that MIS-C differs significantly from severe coronavirus infection in children and adolescents.
Compared with patients with severe COVID-19, patients with MIS-C were more likely to be between the ages of 6 and 12, and the proportion of children and adolescents with a minority background affected is lower.
CHILDHOOD SYNDROME: In April of last year, a 14-year-old boy was hospitalized in the United States with mysterious symptoms. It turned out to be MIS-C. Photo: Progress in Pediatric Cardiology
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A total of 398 of the 539 patients with MIS-C and 253 of the 577 patients with severe COVID-19 were admitted to the intensive care unit.
Ten patients with MIS-C and 8 patients with coronavirus disease died in the hospital.
– What do you think of the findings of this study?
– The findings are important because they show two quite different complications of infection in children and adolescents: what occurs in acute infection and the MIS-C that occurs after infection, says pediatrician Ketil Størdal from Oslo University Hospital, who he is also a professor at the University of Oslo.
Occurs in healthy people
Størdal points out that the patients affected by this are quite different in terms of age, ethnicity, and not least the underlying disease.
– Severe acute infection usually affects those who are already sick and slightly older children and adolescents. MIS-C can occur in children who are already healthy and usually between the ages of 6 and 12, says the teacher.
According to the new study, 61 percent of coronavirus patients had at least one underlying condition, while only 31 percent of MIS-C patients had an underlying disease.
– This is a long and comprehensive article on the complications of SARS-CoV-2, which fortunately we have not seen much in Norway. Less than 0.5 percent of infected children and young people in Norway are hospitalized, Størdal notes.
– Why are the findings of the US study important knowledge?
Important
– The findings are not surprising and agree well with what has been seen in other, but smaller, studies on risk factors for complicated infection, says the pediatrician.
Størdal highlights the following three reasons why the recent study is important:
The prognosis for MIS-C is good. Less than two percent die, as previously reported. About a third had an effect on the heart, but it disappeared within 30 days in 80-90 percent of these.
2. As vaccination gradually becomes relevant for children and youth, it is important to know which children and youth are most at risk, so that you can prioritize these first.
3. Pediatricians treating these children can use good data on typical findings during examinations and responses to laboratory tests.
