Covid-19 hits elderly people particularly hard, with severe disease and high mortality. That’s sad, but society may rationalize the loss, by saying, “He led a good life.” When a child contracts a serious disease and dies from it, the loss is far worse than just sad. The world will never know what that child might have accomplished had she lived. The parents will suffer a loss that I can’t even imagine.
The press has made a point of saying that mortality from Covid-19 is very low in young children, and then increases steadily as people advance from one age cohort to the next. That may be true for the immediate effects of Covid-19, say for the first month or so. However, in a fraction of the children who recover from a Covid-19 infection, a second disease strikes a few weeks later that is far worse than the first. According to a systematic review of studies conducted during the first half of 2020, a small fraction of the children who had contracted and recovered from Covid-19, even those who never showed any symptoms of the disease, appeared on the hospital doorstep with a serious new disease a few weeks later.
This Covid-19-associated disease has been named multisystem inflammatory syndrome in children (MIS-C) by the CDC and WHO, and also named paediatric multisystem inflammatory syndrome temporarily associated with Covid-19 (PIMS-TS) by the Royal College of Paediatrics and Child Health (RCPCH) in the UK. I’ll refer to it as MIS-C. Most children diagnosed with MIS-C required treatment in a hospital intensive care unit. The death rate of children from 8 to 10 years old from MIS-C was 1.7%, much higher than age-matched Covid-19 patients, whose death rate was only 0.09%. The death rate among the MIS-C children was almost 20 times higher than the death rate of similar children from Covid-19.
The danger from MIS-C is due to the body’s hyperinflammatory reaction to something that was left behind after the patient had been pronounced cured and released from the hospital. Whereas most of the danger from Covid-19 is due to the body’s inflammatory reaction to the virus, the situation with MIS-C is much worse. Once again, the culprit is an inflammatory reaction, but in this case the reaction is much more serious, hyperinflammatory rather than merely inflammatory.
Treatments that are effective against MIS-C include intravenous immunoglobulin and corticosteroids, both of which have the effect of depressing an overactive immune system.
Although it appears that MIS-C can appear in children as a sequel to an infection by the SARS-Cov-2 coronavirus, at this point we don’t know whether there is a sequel to MIS-C that we should be on the lookout for. To be safe, or at least as safe as possible, any child who has tested positive for a SARS-Cov-2 infection should be monitored on an ongoing basis for any possible unpleasant surprises that might be lurking in their body, only to appear at a later date.
It’s tiring to go week after week and month after month, practicing social distancing, mask wearing, and hand washing, in the interest of protecting ourselves and others. However, it is important to not flag in our efforts. What we already know about the consequences of Covid-19 are bad enough. The emergence of MIS-C warns us that we still do not know the full scope of the challenge that we face. It’s important that we all follow the proven safety protocols that have been recommended by the CDC and WHO. We will come out on the other side of this after a safe and effective vaccine has been widely distributed. All we have to do is keep safe until then.
BIO:
Allen G. Taylor is a 40-year veteran of the computer industry and the author of over 40 books, including Develop Microsoft HoloLens Apps Now, Get Fit with Apple Watch, Cruise for Free, SQL For Dummies, 9th Edition, Crystal Reports 2008 For Dummies, Database Development For Dummies, Access Power Programming with VBA, and SQL All-In-One For Dummies, Third Edition. He lectures internationally on astronomy, databases, innovation, and entrepreneurship. He also teaches database development and Crystal Reports through a leading online education provider. For the latest news on Allen’s activities, check out his blog at wwwallengtaylor.com or contact him at allen.taylor@ieee.org.