The recent surge in COVID-19 cases may result in an increase in cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in the coming weeks.
Speaking at a COVID-19 news conference on Monday, Dr Joanne Paul, Medical Chief of Staff at the Eric Williams Medical Sciences Centre stated that there are currently 40 confirmed cases of the MIS-C in Trinidad and Tobago, 25 of which are COVID-19 positive and 15 negatives.
However, she said, experts expect this number to rise towards the end of June and into early July as the syndrome typically presents four to six weeks after a surge in viral cases among adults.
“MIS-C usually comes up about four to six weeks after the adult surge of COVID. So, we have seen our surge in May so we are expecting in late June to Early July there might be a possibility of some increased cases. With that, I was speaking to Dr Ronan Ramroop, he is our pediatric cardiologist and our numbers as of today is 40 confirmed MIS-C cases in Trinidad, we have 25 that are COVID PCR positive or antibody positive and we have 15 that are PCR or antibody negative Remember that because MIS-C comes after COVID infection, it's really an immune response to the infection so you might not be positive. NO deaths to date,” she said.
According to Paul, the syndrome presents similarly to severe COVID-19 in children, exhibiting symptoms linked to the brain, heart and bowel. In these severe cases, she said, diarrhea, vomiting, high heart rate, lethargy, paleness, confusion and drowsiness are prevalent.
“Although we know that the majority of children do not have severe covid, at least one percent of them will be admitted to hospital with severe COVID so it is not unusual. The risk factors are less than two years old, in addition obesity, diabetes and genetic factors. The key thing to look out for is not like adults where they would have respiratory signs. They would have other symptoms, for instance GI or gastrointestinal, bowel. The first thing they will have is diarrhea. We are looking at brain, heart and bowel, those three systems in particular are affected in children much more than respiratory. In severe COVID you will see those three systems affected and you will have to be aware of that,” she said.
MIS-C however, she said, includes these symptoms with additional symptoms of the mucus membrane, red eyes, red throat, red lips, tongue, red palms, red soles of the feet and COVID fingers or COVID toes.
“So, there will be blueish blackish marks almost like clots and also a rash anywhere. So, for the next few weeks, I am appealing to the guardians, the parents to make sure you have high awareness,” she said.
In cases where young people suddenly succumb to the virus, she said, this can be attributed to genetic risk factors and the virus’ effect on the lungs and the formation of blood clots. The symptoms of severe COVID-19 in children may also be present in young people. Some she added, may be affected by headaches.
“That is not just for children but for young people also you will have headaches and they will be affected. We may think to ourselves that only those with comorbidities, only those who are older may be affected, you can be so surprised by having a young person affected. If you look at the signs of it, although it is not common, they can also have genetic factors. “
“With COVID-19 how it affects the lung lining to cause something called ARBS (angiotensin receptor blockers), it also affects clots. It produces small clots or large clots. When you have the small clots, those affect your oxygen levels so when we have low ones that may be a small clot formation. When we have a large clot that might lead to sudden death, so we still can have a few cases where young people are affected by severe COVID,” she said.
Though children have fewer viral receptors and are less able to contract and spread the virus, she said, they are still capable of transmitting the virus to at-risk persons. Those who do develop mild symptoms, she said, should be monitored by their guardians, said Paul.