Mis-C, the post Covid syndrome that affects children. The alarm from pediatricians

Mis-C, the post Covid syndrome that affects children. The alarm from pediatricians
Mis-C, the post Covid syndrome that affects children. The alarm from pediatricians

The alarm went off in the last year for the growing number of hospitalizations. In Veneto, where the contagions for the virus have given no respite in the last week (with a slight decrease in the weekend) and there are 15,922 positives, 46 have been hospitalized: young and very young people who have been diagnosed the Mis-C, multisystem inflammatory syndrome. A new acronym with which we risk acquiring a tragic familiarity, linguistic and more. The post pathology Covid, identified for the first time in the United Kingdom in 2020, it mainly affects young people and in particular children and arises after a few weeks (on average between two and six) from the infection of Coronavirus, even in a mild form. In the spring of 2020, a letter was also sent from the Gaslini hospital in Genoa, addressed to 11 thousand paediatrics enrolled in the Italian Society of Pediatrics, to alert them and report the new syndrome, identifying the times of onset and symptoms: fever, rashes, disorders intestinal and inflammation of internal organs.

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CONSEQUENCE OF COVID
The correlation with Covid-19 infection is due to the temporal link. The cases diagnosed concern very young subjects who had tested positive for the virus a few weeks earlier or had a strong antibody load, detected with a serological test. Or, again, they had very recent contacts with people affected by Coronavirus.

SYMPTOMS
High fever, gastrointestinal symptoms (abdominal pain, nausea and vomiting), myocardial suffering with heart failure, hypotension and shock, and neurological alterations (aseptic meningitis and encephalitis) are the symptoms found in Gaslini on young patients diagnosed with Mis- C. But in addition to these clinical manifestations – a note from the hospital clarified – many children develop some of the typical signs and symptoms of Kawasaki disease (a known pediatric disease characterized by inflammation of the blood vessels), in particular skin rash, conjunctivitis and alterations of the mucosa of the lips, as well as dilations (aneurysms) of the coronary arteries. It would not be a direct action of Covid, but the syndrome would have a post-infectious genesis, due to an abnormal immune reaction to the viral infection, in patients who had a particular genetic predisposition.

HOW IT IS CARED FOR
MIS-C is treatable with intravenous immunoglobulin (the same treatment as Kawasaki disease), high-dose corticosteroids, and, in severe cases, anakinra (a biologic drug that inhibits a pro-inflammatory cytokine, ‘interleukin-1).

RISKS TO CHILDREN

One in seven children risk serious consequences from the infection. The FDA, the American drug authority, has already authorized the vaccination of under 12s with two reduced doses of Pfizer, one third of those reserved for adults and one million children have already started the cycle. The EMA could instead pronounce itself in the coming weeks. Children are less likely than adults to contract severe forms, but for the 6.5 million pediatric patients infected until early November, the dangers have been those related to long Covid syndromes, just like Mis-C which , beautiful US, 2,316 children were diagnosed. According to the calculations of the FDA, the vaccine for one million under 12 would avoid 58 thousand infections, 241 hospitalizations in normal wards, 77 in intensive care and one death.

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