Alberta logs 23 cases of pediatric inflammatory condition linked to COVID-19 infection

Doctors in Alberta say children who develop the rare inflammatory condition Multisystem Inflammatory Syndrome in Children, also known as MIS-C, after a COVID-19 infection, can often end up in the ICU.

On May 28, Alberta Health said there have been 23 confirmed cases of MIS-C since March 2020, and each case required hospitalization. Doctors say the actual number of cases is likely higher because of a delay in reporting.

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Alberta’s first confirmed case of MIS-C was reported in May 2020. Alberta Health says no deaths have been associated with MIS-C; all 23 cases have recovered.

1:46 BC 19 year old hospitalized with rare COVID-linked syndrome, mostly found in children BC 19-year-old hospitalized with rare COVID-linked syndrome, mostly found in children – May 15, 2021

dr. Daniah Basodan, a pediatric rheumatologist at Stollery Children’s Hospital, said the majority of patients are between the ages of six and 10, although there are patients as young as toddlers and as old as teens. She said some children had symptomatic SARS-COVID-2, while others had an asymptomatic infection.

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The inflammatory syndrome, which can affect multiple body systems, can cause a persistent fever lasting at least three days, skin rash, conjunctivitis (also known as pink eye), really red lips, and swelling of the hands or feet.

Children may also experience abdominal pain, vomiting or diarrhea. One side effect is inflammation of the heart.

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“In the fall of 2020 we started seeing cases. We had our peak cases in December to January and we were seeing about one to two cases a week,” Basodan said.

“Right now we are somewhere [around] one case every two weeks.”

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dr. Joan Robinson, an infectious disease pediatrician at Stollery Children’s Hospital, said it is still not clear why some children develop the inflammatory disease. When they do, she says, it’s usually two to eight weeks after they have a SARS-COVID-2 infection.

Robinson said it is not certain whether all cases require hospitalization.

“But we do think that most cases require hospital care. In fact, in Alberta, about half of them ended up in intensive care because they developed shock.”

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Basodan said MIS-C patients who come in with shock or low blood pressure are more likely to be admitted to the ICU.

“They may need medication to support their heart and support their blood pressure,” she said.

The condition can be treated with steroids and intravenous immunoglobulin.

“Most children are dramatically better within a day and often go from the ICU to the ward the next day. The median stay, the average stay, is about six days in the hospital,” Robinson said.

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The condition is often compared to Kawasaki disease, another inflammatory disease, but much about why MIS-C develops is a mystery.

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“We don’t understand why these kids have a different immune response… It’s really hard to understand why some kids get it. It’s probably far less than 1 in 1,000 children who become infected with SARS-COVID-2 and later get MIS-C,” Robinson said.

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“There are many different theories about how the immune system, once it has recovered from a COVID-19 infection, could be the source for this…inflammatory response, but we don’t fully understand this process,” Basodan said.

As for whether there are long-term effects on children, both doctors said it’s still not clear.

“We hope there are no long-term consequences, but certainly a small percentage of children will die if they have MIS-C. I don’t think there have been any deaths in Canada yet, but in the US,” Robinson said.

Likewise, Basodan said most patients recover, but the long-term effects of MIS-C remain unknown.

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