Concern over post-COVID inflammatory syndrome in children

Complication may manifest three to four weeks after infection; early identification important

June 20, 2021 11:09 pm | Updated 11:09 pm IST - KOCHI

A child reacts while a doctor takes a nasal swab to test for SARS-CoV-2 at a primary healthcare centre in Kochi.

A child reacts while a doctor takes a nasal swab to test for SARS-CoV-2 at a primary healthcare centre in Kochi.

Children below 10 years currently constitute around 9% of the active caseload in Ernakulam. Doctors say that children have mostly had mild COVID-19 symptoms so far, though post-COVID inflammatory syndrome remains a worry.

Of the 13,839 active cases on Saturday, 1,254 are children below the age of 10, and 1,676 are below the age of 20.

Multisystem Inflammatory Syndrome in Children (MISC), a post-COVID complication, can manifest three to four weeks after asymptomatic or symptomatic infection, and early identification is important, according to State government guidelines issued earlier this month.

“We have had around six cases of MISC at the Government Medical College Hospital (MCH) so far and they have all recovered. While one case was reported in the first wave, the rest were seen during the second,” said Dr. Shiji Jacob, head of the department of paediatrics and neonatology at the MCH. “It has varied presentation in the less-than-19-years age group. Symptoms can include persistent fever, coagulopathy, stomach ache, fall in blood pressure, red rashes over the body, and elevated inflammatory markers in the blood. We had a child here recently who presented symptoms of nephritis, while others have been admitted with diarrhoea and vomiting, or typhoid-like symptoms. Since symptoms are not typical, it is possible that people may miss it,” she said.

“If MISC is not identified and treated quickly, it can become life threatening. It can develop even in children who had no serious COVID-19 symptoms,” said Dr. Peter Vazhayil, associate professor, department of paediatrics and neonatology at the MCH.

A paediatric intensive care unit was available at the Government Medical College Hospital, besides facilities at the Ernakulam General Hospital to take care of children who test positive, said Dr. Mathews Numpeli, district programme manager, National Health Mission. An ICU facility for children was also being readied at the Aluva District Hospital, he said. “In private hospitals in the district, we have seen around two to three cases of MISC so far, and they have recovered,” he said.

A total of 23,335 children below 10 years, and 33,585 children in the 10 to 20 age group have tested positive for the virus so far in Ernakulam. This is out of a cumulative case load of over 3 lakh cases recorded so far. The highest number of cases have been recorded in the 20 to 30 age group (66,147).

Going by the State government guidelines, children who are asymptomatic or with mild COVID symptoms may remain at home. Children with persistent fever or worsening cough beyond five days of illness should be referred to hospitals with a paediatric ward. The proportion of cases among children was in keeping with the surge seen across age groups, said Dr. Numpeli.

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