Health Tips

Multisystem inflammatory syndrome in children (MIS-C)

MIS-C is a rare, serious complication, which is closely related to COVID-19 infection.

MIS-C is also referred to as pediatric multisystem inflammatory system (PMIS). Less than 1% of COVID-19 positive children develop MIS-C, however, most of them are admitted into ICU for better monitoring and treatment.

Most children who become infected with the COVID-19 virus have mild illnesses. However, there is a small population of children who go on to develop MIS-C, in which some organs and tissues such as heart, lungs, blood vessels, kidneys, gut, brain, skin, or eyes become severely inflamed. 

Usually, the MIS-C symptoms start to show up between 2 to 6 weeks after tested positive. In Malaysia, 174 children experienced and were diagnosed with MIS-C between June 2020 and December 2021, after being infected with COVID-19 infection.

In fact, in many cases, the duration of time between acute infection and onset of MIS-C symptoms is unknown as the child was asymptomatic at that time of acute infection.

MIS-C infected children may have:

• Fever over 38.0°C for more than 24 hours

• Skin rash

• Stomach pain, persistent vomiting or diarrhoea

• Headache, confusion, irritability or lethargy

• Blood-shot eyes

• Redness and swelling of the mouth, lips, and throat

• Redness and swelling of hands and feet

Due to the widespread and generalized symptoms, MIS-C can easily mimic other conditions that are closely related to this group of patients such as Kawasaki disease and toxic shock syndrome.

Severe MIS-C warning signs include:

• Difficulty in breathing

• Pain or pressure in the chest that doesn’t go away

• Confusion or unusual behaviour

• Severe stomach pain

• Inability to wake or stay awake

Bring your child to the nearest hospital once he/she is present with one of these signs.

What are the chances that your child might get MIS-C?

Truth is, there is not much information about MIS-C and how it affects children. The exact cause of MIS-C is not known yet, but it appears to be an excessive immune response in relation to COVID-19 infection. There is also a lack of information on which group of children and if there are any particular health conditions in children that make them more prone and likely to get MIS-C. CDC, Centers for Disease Control and Prevention is still working on trying to understand this subject matter.

So, what can you do?

Based on the limited knowledge on MIS-C, the best way to protect your child is by preventing your child and other household members from getting COVID-19 infection. Wash or sanitize your hands frequently, practice double masking, the golden rule always works. 

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We are currently preparing to transition into the endemic phase of COVID-19, which aims to allow Malaysians to return to near-normal life as pre-COVID era. Hence, it is extremely important to get yourself and your child vaccinated if you have not already done so to prevent serious complications. Worry not, children’s vaccines are safe.

All in all

Multiple inflammatory syndrome in children is a serious complication resulting from COVID-19 infection, which may lead to several organ damage. It is not known how MIS-C affects children. Therefore, every 5 to 12 years old child is encouraged to be vaccinated to reduce the risk of getting a severe COVID-19 infection, developing serious complications that result in hospitalization and ICU admission.

For updated information, please visit PICKids official website.

Medically reviewed by Ashwini Nair, MB BCh BAO.

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References:

1. CDC. Multisystem Inflammatory Syndrome (MIS). Centers for Disease Control and Prevention. Published February 11, 2020. Accessed March 16, 2022. https://www.cdc.gov/mis/mis-c/hcp/index.html

2. COVID-19: Multisystem inflammatory syndrome in children (MIS-C) management and outcome - UpToDate. Accessed March 16, 2022. https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-management-and-outcome?search=multiple%20inflammatory%20syndrome&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

Written by

DOC2US Editorial Team