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Q&A: How does multisystem inflammatory syndrome (MIS-C) affect children, teens?

Symptoms include unusual rashes, fatigue, bloodshot eyes, abdominal pain, according to health officials

SAN ANTONIO – One of the small comforts we’ve been able to take in during the pandemic is the fact that children were less likely to experience serious symptoms of COVID-19.

But now, health care providers are seeing something called a multisystem inflammatory syndrome, or MIS-C.

Dr. Roberts Sanders, medical director of University Health System’s downtown Pedi Express urgent care clinic, helped get to the bottom of some questions associated with the newly discovered inflammatory syndrome. Some children who have tested positive for the virus can develop an inflammatory syndrome that affects the vascular system and potentially the heart.

1. What is MIS-C?

The Centers for Disease Control and Prevention defines MIS-C as a condition in which different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.

University Health System stated that many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19.

MIS-C can be serious, and even deadly, but most children who were diagnosed have gotten better with medical care.

2. How much of a danger is MIS-C to children?

“The lucky thing about this whole deal is that it’s extremely rare," Sanders said. "We do not see it a lot, but it is one of these new complications that we’ve seen from COVID-19. This is a newly minted, still pretty vague clinical syndrome with very loose diagnostic criteria, so we have more questions than answers. We don’t want to be alarmist, but we do want to increase awareness because the symptoms can often look like other, less dangerous conditions – and so far, that’s what they’ve usually turned out to be.”

Sanders noted that young people have also been getting rashes and frostbite-like symptoms on their feet that have earned the nickname “COVID toes.”

“It is likely caused by the microvascular damage the virus is doing,” Sanders said.

3. What are the symptoms parents and caregivers should be looking for?

  • Unusual rashes
  • Fatigue
  • Fever
  • Cough
  • Sore throat
  • Bloodshot eyes
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Trouble breathing

The biggest thing to look for is prolonged fever, meaning fever that lasts more than a couple of days.

The early symptoms can resemble more ordinary, less dangerous conditions.

4. What should parents do if a child has MIS-C symptoms?

Keep in touch with your child’s pediatrician -- and the physician should help monitor the child and decide whether to take them in for an appointment or to an emergency room.

Parents can also set up telehealth appointments with Pedi Express urgent care, where a provider can help triage the symptoms and determine whether they should continue to monitor the child at home, make an in-person appointment or take their child to an emergency room.


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