"Immense Inflammation" From Post-COVID Syndrome Severely Damages Children’s Hearts

Post-Covid-19 inflammatory syndrome severely damages children's hearts: Study

Post-Covid-19 inflammatory syndrome severely damages children's hearts: Study

Multisystem inflammatory syndrome in children (MIS-C), believed to be linked to COVID-19, damages the heart to such an extent that some children will need lifelong monitoring and interventions, said the senior author of a medical literature review published September 4 in EClinicalMedicine, a journal of The Lancet.

Moreover, according to Alvaro Moreira from Texas Health Sciences Center University, MIS-C can occur 3-4 weeks after the virus is infected, even in asymptomatic cases.

'Evidence suggests that children with MIS-C have enormous inflammation and potential tissue injury to the heart, and we will need to follow these children closely to understand what implications they may have in the long term, ' Moreira said. This is what concerning pediatricians and neonatologists around the world in which children get exaggerated inflammation without even exhibiting symptoms.

In a comprehensive new review of medical research into MIS-C, all of it from this year, Moreira and his team uncovered nearly 40 observational studies involving 662 child patients in total who developed the syndrome. Scientists also found that out of the 600 cases of inflammatory syndrome which were part of their study about 71 kids had to be admitted into the Intensive Care Unit (ICU). 60 per cent were presented with shock. Patients showed fevers in every case, and the majority also manifested abdominal pain or diarrhea (73.7% of cases) and vomiting (68.3%). While 22.2% of the children required mechanical ventilation, more than 4% required extracorporeal membrane oxygenation (ECMO) and 11 children died.

'This research highlights that, unlike Kawasaki disease, MIS-C is associated with SARS-CoV-2 infection with different clinical and immune findings'.

'It can be lethal because it affects multiple organ systems.

The good news is that MIS-C patients can be effectively treated with therapies commonly used for Kawasaki - immunoglobulin, and glucocorticosteroids, Dr. Moreira noted.

'Almost 90 per cent of the children (581) underwent an echocardiogram because they had such a significant cardiac manifestation of the disease, ' Moreira said.

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The firms, including Pfizer and Merck, said they would only apply for regulatory approval after vaccines went through three phases of clinical study.

In addition, this study found differences in T-cell subsets and cytokine mediators, which place MIS-C at the junction of Kawasaki disease and immune states of acute SARS-CoV-2 infection in children on the one hand, and the hyperinflammation observed in adults with severe forms of COVID-19 on the other one. Researchers reiterated that this figure is much higher than the 0.09% mortality rate observed in children with coronavirus.

Nearly 10% of children had an aneurysm of a coronary vessel.

"These are children who are going to need strict observation and follow-up with multiple ultrasounds to see if this will br resolved or if it is something they will have for the rest of their lives".

'Generally, in both adults and children, we are seeing that patients who are obese will have a worse outcome, ' Moreira said.

MIS-C was first reported in late April in Britain.

Now, several months into the COVID-19 pandemic, we're getting a clearer picture of what MIS-C looks like, although there's still much we don't understand about the syndrome - as well as what the long-term recovery prospects will be for the young people who experience this severe condition.

Citing an example of this abnormality, they said, the molecular marker troponin used in adults to diagnose heart attacks, was 50 times its normal level in children with MIS-C.

"Evidence suggests that children with MIS-C have vast inflammation and potential tissue injury to the heart, and we will need to follow these children closely to understand what implications they may have in the long term", Dr. Moreira said.

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