Child with post-COVID MIS-C recovers at Kochi hospital

Early diagnosis and intervention crucial in MIS-C treatment, say doctors

An 11-year-old in Ernakulam with a severe case of post-COVID Multisystem Inflammatory Syndrome in Children (MIS-C) was rescued using ECMO (extracorporeal membrane oxygenation). Doctors who treated the child at Amrita Hospital in Kochi said early diagnosis and intervention remained crucial in MIS-C cases.

When the child was brought to the hospital, the inflammatory condition had already affected his heart muscles. Pumping of the heart was hit, and blood pressure was critically low, said Dr. Sajith Kesavan, head of the department of paediatric pulmonary and critical care at the hospital. Since the child had positive antibody titers to COVID in his blood, doctors suspected that he was exposed to the infection and might have had asymptomatic COVID-19.

The team of specialists decided to put the child on ECMO to give the heart a chance to recover and time for steroids and IV immunoglobin to act. The ECMO machine pumps blood and oxygenates it, letting the heart rest. Three days later, he had regained enough heart function and could be taken off the machine. The child, who is well on the way to recovery, will be discharged soon. “Kids with MIS-C do well if they are diagnosed early,” Dr. Kesavan said at an online session where doctors elaborated on the 11-year-old’s case. The child’s parents said he had developed fever, vomiting, diarrhoea, and red eyes and was taken to the hospital on the third day after fever began.

MIS-C can have different presentations, though the heart is most commonly affected, said Dr. Suma Balan, paediatric rheumatologist at the hospital. Symptoms include severe fatigue, fever lasting more than a day, rashes, red eyes, abdominal pain, vomiting, and diarrhoea. The doctors clarified that not all fevers are a sign of MIS-C. There are no predictors for which the child might get MIS-C, since it is due to the inherent activation of one’s own immune system, Dr. Balan said. “Incidence of serious COVID infection in children is low,” she added.

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