Post-COVID syndrome: A new childhood disease that severely damages children's heart

This new childhood disease associated with COVID-19 infection can damage the heart to such an extent that some children will need lifelong monitoring and intervention, say experts.

Reports are emerging of people experiencing poor health even after recovering from COVID-19 infection. Doctors are referring to this phenomenon as "post-COVID syndrome." Many people experience persistent fatigue, even three or four months later after an acute episode of Covid-19. Unlike influenza that typically infects solely the respiratory organs, the novel coronavirus attacks multiple organs. For example, it can infect cells in the gastrointestinal tract, cardiovascular system, skin, kidneys, and nervous system. Researchers have also found the prevalence of a dangerous childhood disease associated with COVID-19.

Some children developed multisystem inflammatory syndrome in children (MIS-C), also known as a pediatric inflammatory multisystem syndrome, after COVID-19 infection. This post-COVID syndrome can severely damage the heart of children. In fact, some children with this disease may need lifelong monitoring and interventions, warned a medical literature review published Sept. 4 in EClinicalMedicine, a journal of The Lancet.

MIS-C can strike children after asymptomaticCOVID-19infection

The authors reviewed 662 MIS-C cases reported worldwide between Jan. 1 and July 25. Based on these case studies, they suggested that MIS-C can strike even healthy children three or four weeks after asymptomatic COVID-19 infections, without any warning signs.

Children might have no symptoms after the COVID-19 infection, and a few weeks later, they may develop this exaggerated inflammation in the body, said senior author Alvaro Moreira, MD, MSc, of The University of Texas Health Science Center at San Antonio.

Among the 662 MIS-C cases they reviewed, 71% of the children were admitted to the intensive care unit (ICU), and 60% presented with shock. All of them had a fever, over 73% had abdominal pain or diarrhea, and 68.3% suffered vomiting. Echocardiogram (EKG) test results of 54% of the children showed abnormal. While 22.2% of the children required mechanical ventilation, more than 4% required extracorporeal membrane oxygenation (ECMO) and 11 children died.

MIS-Cmore dangerous than Kawasaki disease and toxic shock syndrome

According to Dr. Moreira, this new childhood disease can be lethal because it affects multiple organ systems - the heart, lungs, gastrointestinal system, and the neurologic system.

MIS-C seems to be more dangerous than Kawasaki disease and toxic shock syndrome as the amount of inflammation in MIS-C surpasses the two similar pediatric conditions.

The good news is that MIS-C patients can be effectively treated with therapies commonly used for Kawasaki - immunoglobulin, and glucocorticosteroids, Dr. Moreira noted.

Obese or overweight children may face the worst COVID-19 outcomes

Almost 90% of the children with MIS-C had a significant cardiac manifestation of the disease. These include dilation of coronary blood vessels (a phenomenon is also seen in Kawasaki disease), and depressed ejection fraction, which reduces the heart's ability to pump oxygenated blood to the tissues of the body.

Some children had an aneurysm of a coronary vessel, a stretching or ballooning of the blood vessel. These children are at the most risk of a future event and they are going to require significant observation and follow-up with multiple ultrasounds, Dr. Moreira said.

The researchers also found that almost half of patients who had MIS-C had an underlying medical condition, and of those, half of the individuals were obese or overweight. This indicates that COVID-19 patients who are obese will have a worse outcome, both in adults and children.