Multisystem Inflammatory Syndrome in Children

Multisystem inflammatory syndrome in children (MIS-C) is a rare systemic illness involving persistent fever and extreme inflammation following exposure to SARS-CoV-2, the virus responsible for COVID-19. It can rapidly lead to medical emergencies such as insufficient blood flow around the body (a condition known as shock). Failure of one or more organs can occur. Its clinical features may appear somewhat similar to Kawasaki disease. Nevertheless, it appears to be a separate syndrome. Older children tend to be affected. In adults, a similar condition has occasionally been reported, which has been called multisystem inflammatory syndrome in adults (MIS-A). Having MIS-C of great concern for parents and even Doctors, Siddha Spirituality of Swami Hardas Life System brings out here some management tips, which can be practiced at home.

What does Multisystem inflammatory syndrome in children Mean?

Multisystem inflammatory syndrome in children (MIS-C) is a serious condition that appears to be linked to coronavirus disease 2019 (COVID-19). Most children who become infected with the coronavirus have only a mild illness. But in children who go on to develop MIS-C, some organs and tissues e.g. the heart, lungs, blood vessels, kidneys, digestive system, brain, skin, or eyes become severely inflamed.

Which are the Symptoms of Multisystem inflammatory syndrome in children?

Symptoms of the multisystem inflammatory syndrome in children (MIS-C) include those below, though not all children have the same symptoms:

• Fever that lasts 24 hours or longer
• Vomiting
• Diarrhea
• Pain in the stomach
• Skin rash
• Feeling unusually tired
• Fast heartbeat
• Rapid breathing
• Red eyes
• Redness or swelling of the lips and tongue
• Redness or swelling of the hands or feet
• Headache, dizziness, or lightheadedness
• Enlarged lymph nodes

What are the emergency warning signs of Multisystem inflammatory syndrome in children?

• Severe stomach pain
• Difficulty breathing
• Pale, gray, or blue-colored skin, lips, or nail beds — depending on skin tone
• New confusion
• Inability to wake up or stay awake

When to see a doctor?

If your child has any of the emergency warning signs listed above or is severely sick with other signs and symptoms, get care immediately. Take your child to the nearest emergency department or call 911 or your local emergency number.

If your child isn’t severely ill but shows other signs or symptoms of MIS-C, contact your child’s doctor right away for advice. Doctors may want to do tests e.g. blood tests, or imaging tests of the chest, heart, or abdomen to check for areas of inflammation and other signs of Multisystem inflammatory syndrome in children.

What Causes Multisystem inflammatory syndrome in children?

While it has been hypothesized that the condition is related to COVID-19, it has also been emphasized that the potential link is neither established nor well understood. A temporal association between SARS-CoV-2 infection and clinical presentation of the syndrome is plausible. A causality assessment found that ‘temporality’ was among the five (out of nine) Bradford Hill criteria that supported a causal relationship between SARS-CoV-2 infection and the development of the syndrome.

Further characterization of the syndrome is essential to identify risk factors and help understand causality. It is unclear to what extent this emerging syndrome has a similar etiology to Kawasaki disease, which is currently thought to be triggered by a distinct viral agent. Although some cases resemble toxic shock syndrome, there is no evidence that staphylococcal or streptococcal toxins are involved.

Which are the other names of Multisystem inflammatory syndrome in children?

The various names include:

• Multisystem inflammatory syndrome in children (MIS-C)
• Multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19
• Pediatric inflammatory multisystem syndrome (PIMS)
• Pediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 infection (PIMS-TS)
• Pediatric multisystem inflammatory syndrome (PMIS)
• Kawa-COVID-19
• Systemic inflammatory syndrome in COVID-19 (SISCoV)

How Multisystem inflammatory syndrome in children is Diagnosed?

Diagnosis is by specialist clinical evaluation. Diagnostic suspicion may be raised by unexplained persistent fever and clinically concerning symptoms following exposure to COVID-19. Families need to seek immediate medical care, as the child’s condition can deteriorate rapidly.

Pediatricians’ first involvement is often in the emergency department. Early recognition and multidisciplinary referral to pediatric specialists (in intensive care, infectious diseases, cardiology, hematology, rheumatology, etc.) are essential. Examinations may include:

• Blood tests,
• Chest x-ray,
• Heart ultrasound (echocardiography), and
• Abdominal ultrasound.

Clinicians worldwide have been urged to consider this condition in children who display some or all the features of KAWASAKI DISEASE or toxic shock syndrome.

What are the Differential diagnosis of Multisystem inflammatory syndrome in children?

It is essential to exclude alternative non-infectious and infectious causes of the inflammatory condition, including:

• Bacterial sepsis,
• Staphylococcal and streptococcal shock, and
• Infections associated with myocarditis, such as enterovirus. Other potentially unrelated sources of abdominal pain include appendicitis and mesenteric adenitis.

Differential diagnosis with Kawasaki disease can be challenging, given the lack of a diagnostic test for either condition. It is not currently known whether the newly described condition is superimposable with Kawasaki disease shock syndrome. 

How to Prevent Multisystem inflammatory syndrome in children?

Vaccine availability in the US

In the U.S., the Pfizer-BioNTech COVID-19 vaccine is now available to people age 12 and older. A vaccine can prevent you or your child from getting the COVID-19 virus. If you or your child gets COVID-19, a vaccine could or prevent you or your child from becoming seriously ill.

Vaccine availability in India

Presently a vaccine for children is under trial in India, which will soon be available to protect children.

How parents can prevent MIS-C?

The CDC recommends following these precautions for avoiding exposure to the virus that causes COVID-19:

• Keep hands clean. Wash hands often with soap and water for at least 20 seconds. If soap and water aren’t available, use a hand sanitizer that contains at least 60% alcohol.
• Avoid people who are sick. In particular, avoid people who are coughing, sneezing, or showing other signs that indicate they might be sick and contagious.
• Practice social distancing. This means that you and your child should stay at least 6 feet (2 meters) from other people when outside of your home.
• Wear cloth face masks in public settings. When there is a high risk of COVID-19 transmissions in indoor public places or outdoors, such as at a crowded event or large gathering, both you and your child, if at least 2 years old, should wear face masks that cover the nose and mouth.
• Avoid touching your nose, eyes, and mouth. Encourage your child to follow your lead and avoid touching his or her face.
• Cover your mouth with a tissue or your elbow when you sneeze or cough. You and your child should practice covering your mouths when you sneeze or cough to avoid spreading germs.
• Clean and disinfect high-touch surfaces every day. This includes areas of your home such as doorknobs, light switches, remotes, handles, countertops, tables, chairs, desks, keyboards, faucets, sinks, and toilets.
• Wash clothing and other items as needed. Follow manufacturers’ instructions, using the warmest appropriate water setting on your washing machine. Remember to include washable plush toys.

How doctors will care for your child?

Doctors may do certain tests to look for inflammation or other signs of disease. These tests might include:

• Blood tests
• Chest x-ray
• Heart ultrasound (echocardiogram)
• Abdominal ultrasound

Doctors may provide supportive care for symptoms and may use various medicines to treat inflammation. Parents or caregivers with concerns about their child’s health, including concerns about COVID-19  or MIS-C,  should immediately call a pediatrician or other healthcare provider.

Unknown facts about Multisystem inflammatory syndrome in children?

CDC is still learning about MIS-C and how it affects children. It is unknown if children with certain health conditions are more likely to get MIS-C. These are among the many questions CDC is working to try to understand. All CDC recommendations are based on the best data and science available at the time.

Siddha preventive therapy for Multisystem inflammatory syndrome in children

Siddha preventive therapy includes:

1. Siddha preventive measures

Everybody must practice Siddha preventive measures, whether a person is affected with Multisystem inflammatory syndrome in children or not, but preventive measures are the primary steps for switching on to any other Siddha remedies, and hence they are important. It helps in one’s capability, effectiveness, and productivity, decision-making power, intellectuality, and removing minor health problems. 

Everybody’s tendency is to get attracted to the word free, however, don’t neglect even these Siddha preventive measures are free. Avail of the benefits by practicing them sincerely, and regularly. For the ease of understanding Siddha preventive measures, please watch a video for a live demonstration.

2. Siddha Shaktidata Yog

This unique Siddha Shaktidata Yog of Siddha Spirituality can solve the problems related to Multisystem inflammatory syndrome in children with free Siddha remedies. There is no compulsion of training of ‘Swami Hardas Life System’ methods. This not only gives benefits to self but also it can be used for other affected persons, whether a person is in the same house, distantly available in the same city, same nation or might be in any corner of the world, however, both the procedures have been explained here.

3. Training of Swami Hardas Life System 

Any person irrespective of religion, caste, creed, faith, sex, and age can undergo Swami Hardas Life System training.

What is the right Treatment of Multisystem inflammatory syndrome in children?

Kawasaki disease

Due to the limited information available on this rare new diagnosis, clinical management has been largely based on expert opinion, including knowledge acquired from treating Kawasaki disease and other systemic inflammatory disorders of childhood, in addition to experience with COVID-19 in adults.

Input from the various consulting specialists

Approaches vary. The RCPCH initially outlined a provisional approach to clinical management, including guidance on early medical management, monitoring, and some general principles of treatment; for the UK, a consensus has since been reached regarding a recommended pathway for clinical management.

General considerations

The National Institutes of Health provides some general considerations. The American College of Rheumatology guides clinical management of MIS-C. The American Academy of Pediatrics has also provided some interim guidance. Other proposals have also been made. RCPCH guidance recommends that all affected children should be treated as having suspected COVID-19.

Cardiac and respiratory support

Little specific information is available regarding therapeutic effectiveness. Most children who have been treated for Kawasaki disease have recovered. Supportive care is a mainstay of therapy, and for mild or moderate disease, it may be sufficient. Major complications may respond well to more aggressive supportive care. Cardiac and respiratory support may benefit children who present predominantly with shock.

Treatment of shock

Strategies for clinical management tend to be broadly based on anti-inflammatory medications, treatment of shock, and prevention of thrombosis. Most children have received immunomodulatory treatment with intravenous immunoglobulin (IVIG).

IVIG, with or without corticosteroids

Other anti-inflammatory treatments have been used, including corticosteroids at various doses. Good responses have been recorded for IVIG, with or without corticosteroids. Cases requiring steroids due to resistance to IVIG may be more common than in Kawasaki disease.

Cytokine blockers

In a minority of cases, cytokine blockers have been used as a supplemental therapy to inhibit the production of IL-6 (tocilizumab) or IL-1 (anakinra). Inotropic or vasoactive agents are often used for children with cardiac dysfunction and hypotension. Anticoagulants have been used. Low-dose aspirin has been used as an antiplatelet drug.

Treatment strategies are being considered to prevent serious long-term complications such as coronary artery aneurysms (the main complication of KAWASAKI DISEASE). Close outpatient follow-up by a pediatric cardiology team has been recommended.

Multisystem inflammatory syndrome in Adults

There has been uncertainty as to whether the condition is confined to children, and the appropriateness of excluding adults from case definitions has been questioned. Sporadic reports exist of a similar life-threatening condition, denominated ‘multisystem inflammatory syndrome in adults’ (MIS-A), which also usually requires intensive care.

Conclusion

I am confident that now you have learned about Multisystem inflammatory syndrome in children, symptoms, causes, diagnosis, prevention, treatment, and free Siddha remedies, without money and medicines. Now, you have become self-sufficient, hence it’s the right time to use your acquired knowledge for solving problems as per the provision available in Siddha Spirituality of Swami Hardas Life System.

However, keep learning and practicing the free Siddha Energy Remedies, which would help guide how to solve various problems regarding health, peace, and progress, without money and medicines.

After reading this article, what are your thoughts? Would you please put more efforts into enhancing or updating your knowledge? Let me know your precious thoughts. 

Frequently asked questions

Here are a few frequently asked questions regarding Multisystem inflammatory syndrome in children. Before posting your query, kindly go through them:

Q: What is Multisystem inflammatory syndrome in children? Most children who become infected with the coronavirus have only a mild illness. But in children who go on to develop MIS-C, some organs and tissues e.g. the heart, lungs, blood vessels, kidneys, digestive system, brain, skin, or eyes become severely inflamed.

Reference:

• https://en.wikipedia.org/wiki/Multisystem_inflammatory_syndrome_in_children
• https://www.mayoclinic.org/diseases-conditions/mis-c-in-kids-covid-19/symptoms-causes/syc-20502550
• https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/children/mis-c.html