Covid inflammation syndrome

Data on COVID-19 around the world shows that children generally experience less severe complaints than adults. However, the World Health Organization (WHO) recently reported a complication of COVID-19 in children known as multisystem inflammatory syndrome, or multisystem inflammatory syndrome.

The dangers of COVID-19 do not only come from the SARS-CoV-2 virus itself. Apart from damaging the lungs, this viral infection can also provoke a massive immune response to various organs of the body. The excessive immune response then causes inflammation and in some patients, organ failure.

Multisystem inflammatory syndrome in COVID-19 patients

This rare complication was first reported in the North American and European regions. At that time, several children and adolescents who tested positive for COVID-19 showed symptoms similar to Kawasaki disease and toxic shock syndrome.

A number of reports also stated that the patient experienced acute COVID-19 symptoms accompanied by severe inflammation in several organs at once. This condition results in organ failure and shock in the patient.

Kawasaki disease is a disease that causes inflammation and swelling of blood vessels throughout the body. If not treated immediately, this disease can damage the blood vessels leading to the heart and cause various complications.

Meanwhile, toxic shock syndrome is a blood poisoning condition due to toxins produced by staphylococcal bacteria. This is a rare condition, but can be fatal. Patients are also at risk for multiorgan complications if they are not treated quickly.

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Although similar, the multisystem inflammatory syndrome in children with COVID-19 is different from Kawasaki disease and toxic shock syndrome. However, the three of them both attack various organs in the body simultaneously.

Multisystem inflammatory syndrome is characterized by fever for several days, rash, and abdominal pain. There have also been reports of symptoms of red eyes and swollen lymph nodes. If a child experiences a collection of these symptoms, parents need to immediately contact a doctor to determine next steps.

Diagnosis of multisystem inflammatory syndrome in COVID-19 patients

Inflammatory syndrome in a pediatric COVID-19 patient was initially suspected of being Kawasaki disease and toxic shock syndrome because all three cause similar symptoms. WHO now has criteria for medical personnel to assist with diagnosis.

The main criteria are children and adolescents aged 0-19 years who have a fever for three consecutive days or more. After that, it is necessary to see if there are at least two of the following five conditions:

• The hands, feet, or mouth have a rash, signs of inflammation, or look reddish without oozing.
• Low blood pressure or shock.
• There are signs of heart muscle problems, inflammation of the heart valves, inflammation of the lining of the heart, or coronary artery abnormalities.
• There are signs the blood won't clot.
• Acute indigestion such as diarrhea, vomiting or stomach upset.

In addition to the list of criteria above, doctors also need to confirm whether a COVID-19 patient meets all of the following inflammatory syndrome criteria:

• There is an increase in the sedimentation rate, C-reactive protein, or procalcitonin, which are markers of inflammation.
• Inflammation is not caused by other microbes, including not due to sepsis or toxic shock syndrome.
• Positive for COVID-19 or have had contact with a COVID-19 patient.

Handling given to patients

The Centers for Disease Control and Prevention (CDC) has not provided guidelines for managing multisystem inflammatory syndrome in COVID-19 patients. However, medical personnel have so far provided immunoglobulin injections and intensive care.

According to Sean T. O'Leary, member of the infectious disease committee at the American Academy of Pediatrics, what patients need most is intensive care. Here, doctors can treat each patient according to their individual needs.

If the patient has breathing problems, the doctor will prioritize the use of a ventilator if needed. The same is true of patients who have experienced a drastic drop in blood pressure or organ failure.

Parents also don't need to worry too much. Despite its dire appearance, multisystem inflammatory syndrome is a very rare complication. Recovery can take place better if the child's condition is detected immediately.

There are two things parents can do to protect their children from COVID-19 and its complications. First, parents need to maintain personal and environmental hygiene, and teach children how to prevent transmission of COVID-19.

Second, parents need to carefully observe the child's condition. Keep an eye out for signs of COVID-19 and unusual symptoms in your child. If there are suspicious signs that refer to an inflammatory syndrome, immediately consult your child to a doctor for proper treatment.