After children recover from Covid-19 infection, there is a syndrome that needs to be monitored called Multisystem Inflammatory Syndrome in Children, or MIS-C for short. This syndrome is caused by inflammation in various body systems, including the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal tract.
Although this condition is rare, it is a severe complication, such as myocarditis, which can be life-threatening. However, if diagnosed and treated promptly, patients usually respond well to treatment and recover.
Symptoms for Parents to Watch For
Symptoms can appear from the time the child starts to recover or about 2-6 weeks after infection. The symptoms to watch for are as follows:
- Fever ≥ 38 degrees Celsius lasting more than 24 hours, along with at least 2 of the following symptoms
- Cardiac symptoms such as myocarditis, presenting with easy fatigue, rapid breathing, sweating, palpitations, dizziness, or fainting
- Gastrointestinal symptoms such as vomiting, diarrhea, abdominal pain
- Respiratory symptoms such as sore throat, cough
- Inflammation of mucous membranes such as red eyes, rash
- Neurological abnormalities such as seizures, confusion, meningitis
Generally, MIS-C usually presents with fever along with cardiac and gastrointestinal symptoms. Therefore, parents should mainly watch for fever combined with difficulty breathing, easy fatigue on exertion, sweating, palpitations, and diarrhea. If these symptoms occur, they should promptly see a doctor without waiting for a scheduled follow-up appointment.
Treatment of MIS-C After Recovering from Covid-19
- Supportive treatment such as fluid administration, heart stimulants to increase blood pressure, and oxygen therapy
- Anti-inflammatory medications such as intravenous immunoglobulin and steroids
- About 70% of patients have severe symptoms such as myocarditis and shock, requiring treatment in the intensive care unit (ICU)
Guidelines for Caring for Children After Covid-19 Infection
- Monitor for MIS-C symptoms or promptly see a doctor if abnormal symptoms occur
- Live a New Normal lifestyle: wash hands frequently and recommend wearing masks for children aged 2 years and older
- Children aged 5 years and older with a history of Covid-19 infection are recommended to receive vaccination 12 weeks after infection, counting from the first day of symptoms or, for asymptomatic cases, from the date of a positive RT-PCR or ATK test
- For those who have not received any Covid-19 vaccine, 2 doses are recommended, 8-12 weeks apart
- For those who have received 1 dose of vaccine, a booster dose is recommended
(It is not recommended to receive additional doses if already vaccinated with 2 doses)
- Children who have completed 2 doses of Covid-19 vaccine have a reduced risk of developing MIS-C or reduced severity of MIS-C, including lower rates of hospitalization and intubation
- Children can attend school normally after the infectious period or quarantine as advised by a doctor
- Even after having had Covid-19, reinfection is possible due to ongoing virus mutations
- After recovery, children can receive vaccines according to their age as usual
Dr. Rujira Mongkolkul
Pediatric Respiratory Specialist
Child and Adolescent Health Center, Phyathai 2 Hospital
