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Doctors finding more success treating MIS-C in kids

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A mystery illness

MIS-C typically occurs after a child has recovered from a COVID-19 infection, when the body’s immune response is ramped up. Many MIS-C patients don’t know they previously had COVID-19 because they were asymptomatic. The patient might not get symptoms for MIS-C until up to eight weeks after having the virus.

Symptoms include high fever, rash, and prominent gastrointestinal problems such as pain and diarrhea. Some children also present with neurological symptoms.

There’s no standardized treatment for MIS-C. However, most patients receive an immune modulator to decrease inflammation.

Doctors can diagnose MIS-C after evaluating symptoms, and conducting a series of laboratory and imaging testing. Patients also undergo an antibody test to determine if they previously had COVID-19.

The treatment often consists of steroids and intravenous immunoglobulin — which is taken from the blood plasma of donors.

Nemours Hospital has diagnosed 15 MIS-C cases, most of which have been among teenagers. The hospital system has also diagnosed 240 pediatric COVID-19 cases across its sites in Delaware, Pennsylvania and New Jersey.

Across the border in Philadelphia, St. Christopher’s Hospital has diagnosed about 15 to 25 cases since May, among patients ages 8 and 12. They also diagnosed about 175 pediatric COVID-19 cases.

Patients at both hospitals are now healthy, officials say.

Hospitalized for Easter

Leading up to Easter, Andrew had a mild headache and some pain in his stomach, before developing a fever. He didn’t have a cough or shortness of breath, so his parents didn’t think he had COVID-19.

At first, Ed and Ingrid Lis decided not to take Andrew to the doctor, because they feared he might catch the coronavirus at the doctor’s office.

But on Easter weekend, Andrew’s fever continued to spike, and he complained of significant pain in his abdomen, and an ache on the back of his head and the side of his neck.

“When I started feeling sick, I thought it’s just one of those days you get a cold or something, so I went to bed early,” he said. “And the next day I still wasn’t feeling good … There were some points I was up and could pay attention, and there were some times the pain was so great I couldn’t do anything.”

Early Easter morning, Andrew checked into Nemours, on the advice of his primary care physician, who thought he could have appendicitis or meningitis.

Physicians at Nemours performed bloodwork and various other tests to determine his illness. At first, they thought Andrew might have a gastrointestinal problem. But Andrew’s symptoms continued to worsen. He developed other issues, including a drop in blood pressure, severe diarrhea and a rash. Physicians tested Andrew for every disease they could think of but continued to be stumped on what was wrong.

“Here we were seeing him get increasingly sicker, and not knowing what was going on and hearing the doctors say, ‘We think it might be this, we think it might be that.’ These are the best doctors in the country for treating kids, and they were continuing to seek out an answer for this,” Ed said.

Doctors then became worried about a cardiac dysfunction and told Ed and Ingrid that Andrew had to be moved to the cardiac ICU and be intubated for the best chance of saving his life.

Andrew Lis of Coatesville, Pennsylvania was diagnosed with MIS-C in April after spending 10 days in the hospital. (Courtesy of Ingrid and Ed Lis)

“Nothing prepares you for hearing, ‘We need to do everything we can to save your son’s life.’ It brought my wife and I to our knees,” Ed said. “[But] they were like medical detectives. Even though it was absolutely unsettling not knowing what was going on, what gave us reassurance was these doctors were not going to stop until they could figure out what was wrong. And everything they could do to preserve my son’s life they were going to do.”

Andrew was in the hospital for 10 days before he was able to return home. When research about MIS-C was announced about a week after Andrew’s discharge, the physicians finally had the answers they were looking for.

The whole family was asked to take an antibody test for COVID-19 — Andrew was the only one with positive results.

The family still doesn’t know how Andrew could be the sole member to contract the virus. At the beginning of March, they had taken a trip to Florida together, and after the lockdown started, they all hunkered down at home.

“We’re a large family. We are very close. We’re not scared of showing affection. So, it was strange to find out he was the only one who got sick,” Ingrid said.

Andrew said he is doing well today and was given a clean bill of health by his cardiologist.

https://whyy.org/articles/mis-c-doctors-make-progress-on-covid-related-illness-affecting-kids/

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