COVID-related condition MIS-C can be severe in some children

Hari Gourabathini, MD, pediatric critical care medicine physician at Beacon Children’s Hospital, offers his perspective about caring for children affected by coronavirus and the unseen impacts of the pandemic on our community’s kids. Click here to hear him speak about MIS-C.

The pandemic’s effect at face value

It has been a more than a year since the COVID-19 pandemic started. Not knowing what to expect with the first wave of pandemic, our team at Beacon Children’s Hospital was prepared and determined to provide services to children affected with coronavirus.

We anticipated that we would see many children with comorbidities such as prematurity, birth defects, chronic disease, and other complex conditions affected with coronavirus but, fortunately, the contrary was seen. The children we cared for had either no symptoms or had mild symptoms due to Multisystem Inflammatory Syndrome in Children (MIS-C).

The incidence of MIS-C follows after a surge of coronavirus cases in the community. We witnessed this after the first and second waves in our community as well. Children have mild infections or no symptoms because they have a low number of receptors that the virus attacks to enter the body. The coronavirus has to compete with other viruses and have cross-immunity from other viral infections. Lastly, children have immunity against coronavirus in a different way which we still have as yet to find out. The science is ongoing to determine the exact reason why children may have no symptoms or only mild infections.

MIS-C is the sickest condition seen in the majority of adolescents and some children less than 10 years of age. They can get really sick with a rash, strawberry tongue (white-coated with lumps), pink eye, heart failure, kidney failure and liver injury. MIS-C is an immunological reaction to a virus in your body on a large scale. The good news is that most of these children are discharged home and return back to baseline.

The hidden crises within a pandemic

During this unusual time, we have observed a peculiar pattern of pediatric admissions other than coronavirus infections. We observed a significant impact and toll on the mental health of our children in our community. Not being able to go to school and interact with kids of their own age has had a significant impact on mental health and created missed opportunities for their young personalities to develop.

Sadly, we have seen a surge in non-accidental traumas in children in our community, perhaps due to the unimaginable stress families are going through. We have seen gunshot wounds in children, occurring both accidentally and non-accidentally.

We experienced a surge in suicidal ingestions, especially in children ages 10 to 18 years old. We observed kids who were performing well at school who had developed depression and anxiety issues, and others with previous diagnoses who were not able to obtain counseling services or appointments with their psychiatrists. I would advise parents and get help immediately if your children are showing any signs or symptoms of depression or anxiety.

We have a local population of kids with mental or physical disabilities and their families who need regular support and services from our specialty clinics. They had tremendous difficulty in obtaining these services at the beginning of the pandemic. Telemedicine helped to bridge the gap initially, and now clinics are open and services are available through the valiant efforts of our providers and our health system.

The pandemic also impacted the amount of time parents waited to seek medical care for their children. We observed children coming to us with medical emergencies like diabetic ketoacidosis and surgical emergencies like acute appendicitis much later than during pre-pandemic times. I advise parents and caregivers to obtain help much sooner than later to help prevent complications and a prolonged hospital stay.

Due to the pandemic, lots of children have missed well-child visits and immunizations. Now, more than ever, we encourage parents to schedule and keep those appointments with their child’s doctor.