Post-COVID syndrome may severely damage children’s hearts, the Lancet

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 Lancet.
September 09, 2020 | 14:04
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Post-COVID syndrome may severely damage children’s hearts. (Photo: Northwell)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread throughout the world at an alarming rate. Previous reports suggested that children infected with coronavirus disease 2019 (COVID-19), the condition caused by SARS-CoV-2, were highly resilient and had mild symptoms.

However, earlier this month, a senior author of a medical literature review published in EClinicalMedicine, a journal of The Lancet published a research paper that proves multisystem inflammatory syndrome, a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown. The paper was conducted by 17 researchers from different universities, institutes, and hospitals in the US.

Accordingly, children with multi-organ infection syndrome after Covid-19 may develop cardiovascular symptoms similar to two rare but serious diseases such as Kawasaki disease and toxic shock syndrome (TSS). In some cases, this can lead to a decrease in the ability to pump oxygenated blood from the heart to the body's tissues, or an aneurysm of the heart.

Case studies also show MIS-C can strike seemingly healthy children without warning three or four weeks after asymptomatic infections, said Alvaro Moreira, MD, MSc, of The University of Texas Health Science Center at San Antonio. Dr. Moreira, a neonatologist, is an assistant professor of pediatrics in the university’s Joe R. and Teresa Lozano Long School of Medicine.

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Children with multi-organ infection syndrome after Covid-19 may develop cardiovascular symptoms similar to two rare but serious diseases. (Photo: RFI)

“According to the literature, children did not need to exhibit the classic upper respiratory symptoms of COVID-19 to develop MIS-C, which is frightening,” Dr. Moreira said. “Children might have no symptoms, no one knew they had the disease, and a few weeks later, they may develop this exaggerated inflammation in the body.”

“This is a new childhood disease that is believed to be associated with SARS-CoV-2,” Dr. Moreira said. “It can be lethal because it affects multiple organ systems. Whether it be the heart and the lungs, the gastrointestinal system or the neurologic system, it has so many different faces that initially it was challenging for clinicians to understand.”

The amount of inflammation in MIS-C surpasses two similar pediatric conditions, Kawasaki disease and toxic shock syndrome. “The saving grace is that treating these patients with therapies commonly used for Kawasaki – immunoglobulin and glucocorticosteroids – has been effective,” the University of Texas quoted.

Dr. Moreira and his colleagues studied 662 cases of multi-organ infection syndrome worldwide, which took place from January 1 to July 25. Accordingly, 71% of the children were admitted to the intensive care unit, 60% presented with shock, 100% had fever, 73.7% had abdominal pain or diarrhea, and 68.3% suffered vomiting while 11 children died.

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