A new research suggests that a large number of children who get hospitalised due to Covid-19 develop Multisystem-Inflammatory Syndrome (MIS) that can be fatal. MIS refers to a condition in which a patient has fever and inflammation in multiple organs, for example, the heart, lungs and brain, and high inflammatory markers.
Safdarjung Hospital received 41 Covid-19 patients who were in the age group of 0 to 12 years between April 1 and July 31 last year.
A retrospective study of the clinical manifestations and outcomes in these patients, which has been published in the latest issue of the Journal of Tropical Paediatrics (JTP), shows that 20 (49%) of these children suffered from MIS.
While the non-MIS children were mostly stable and required only supportive therapy, the study says, those suffering from MIS were sick and needed intensive critical care treatment.
Seven (33%) out of 21 non-MIS-C cases required oxygen supplementation compared to 90% of MIS cases, the researchers found. Ventilator support was required in only one out of 21 non-MIS cases while 65% of children suffering from MIS required ventilation at or during hospitalisation, the study says.
The mortality among Covid-19-affected children who developed MIS was nearly 60%. According to the study, 12 out of 20 children suffering from MIS died despite all efforts. In the non-MIS category, the death rate was 1% (only one out of 21 children died).
The research was conducted by Dr Rani Gera, Amitabh Singh, Nidhi Chopra, Harish Chellani and Shobhna Gupta of the pediatric and DR Balvinder Singh Arora of the microbiology department of Safdarjung Hospital. Dr Ravindra Pandey from the biostatistics department of All India Institute of Medical Sciences also contributed to it.
Many of the children included in the study had pre-existing illnesses. The doctors said this could have led to high mortality.
However, they have concluded that acute onset of fever and symptoms, such as seizures or altered sensorium, could be a prominent presentation of MIS and timely intervention could save lives.
Dr Shamsher Dwivedee, chairman of neurosciences at VIMHANS Nayati super specialty hospital, said that such high incidence of MIS and mortality hasn’t been seen in children suffering from Covid-19 in high-income countries or even private hospitals in Delhi.
“We need to explore the role of malnutrition in it. Since Safdarjung gets patients from all strata of the society, one needs to do a subset analysis to examine the influence of malnutrition in Covid-19-related MIS,” he added.