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Dr. Khushboo Parikh is a board certified pediatric cardiologist with Pediatric Cardiology Associates affiliated with Our Lady of the Lake Children’s Hospital in Baton Rouge Louisiana. The coronavirus disease that first emerged in Wuhan, China in December 2019, has generally caused mild illness in children compared to adults. However, over the past five months, reports have emerged of a new multisystem inflammatory disease in children. Dr. Parikh is an expert with this and talks to us about this novel disease and its implications.

Interviewer: So Tell us about this syndrome called MISC in kids. 

Dr. Parikh: MIS-C stands for Multisystem inflammatory syndrome in children. The first reported series of 8 patients with this new syndrome was published in April of 2020, in the United Kingdom. Subsequently, Italy and France reported similar series of 10 and 35 children, respectively. In May last year, the Centers for Disease Control and Prevention formally named this entity Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 and introduced a case definition. So far there are more than two thousand cases in the United states.

Interviewer: How do you diagnose MIS-C?

Dr. Parikh: CDC came up with guidelines for all individuals less than 21 year old. Kids with fevers greater than one day, without any other plausible diagnosis may have MIS-C. Kids must have positive virus or antibodies to SAR-Cov-2 or exposure to a confirmed case within 4 weeks from the symptom onset. There are other minor criteria also defined by the CDC. 

Kids may present with a fever typically along with a combination of rash on the skin, redness of the eyes, nausea, vomiting or headaches. Some may have swelling of the hands or feet. 

Interviewer: How young can this be seen in kids. 

Dr. Parikh: We have seen it affect children in all age groups from 2-19 years. However, at our hospital we have noted teenagers tend to have a more serious form of the illness.

Interviewer: Can you treat this in kids?

Most kids who have mild disease only need close monitoring and treatment of symptoms. More severe cases may need hospital admission with treatment of IVIg or intravenous immune globulin. In our limited knowledge of this condition, the outcomes have been favorable with most children recovering from the illness. Regarding long term outcomes it remains to be seen if the illness causes any long lasting cardiac complications.

Interviewer: How many cases of MIS-C are reported in Louisiana?

Dr. Parikh: MIS-C is a reportable illness and per the Louisiana Department of health, as of February 2021, there have been 124 confirmed cases of MIS-C with 5 deaths.

 

Interviewer: Do children have any sports restrictions after being discharged from the hospital?

Dr. Parikh: Children who are diagnosed with MIS-C along with any cardiac complications are restricted from sports for 3-6 months. 

Interviewer: Any other recommendations for parents and pediatricians regarding this novel illness?

Dr. Parikh: I recommend continued and frequent hand washing, social distancing and wearing a mask when in the vicinity of other people. In the event of fever, especially if it happens after being exposed to a known case of COVID-19 monitor for signs of rash, conjunctivitis, nausea, vomiting, chest pain or headaches. I recommend evaluation in the emergency department if symptoms persist for more than 24hrs.

 

Thank you very much Dr. Parikh for the information on this disease. 

 

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