COVID-19 Cases May Be Down, but Kids Are in Danger as MIS-C Lingers

There’s been a lot of promising news regarding the COVID-19 pandemic recently; cases in most areas of the U.S. are trending downward while testing and vaccination programs are (slowly) helping to curb public anxiety about the virus. This is no time for hubris or a false sense of security, however, as an article just published in the Journal of the American Medical Association reveals newly identified characteristics of children who become ill with multisystem inflammatory syndrome in children (MIS-C). Based on analysis of 1,000 pediatric patients hospitalized in 31 states between March 15 and October 31, 2020, the article notes that children between the ages of 6 and 12 years account for 41% of the cases, and that non-Hispanic black children made up 32% of cases. Maybe most alarming, however, is the finding that 69% of children who developed MIS-C had no underlying conditions. Less surprising is the fact that MIS-C was more likely to occur in children with more complex presentations such as cardiovascular issues without respiratory involvement (which increase risk nearly 2.5-fold) and mucocutaneous issues without cardiorespiratory involvement (a 2.3-fold increase in risk). Further, MIS-C led to a higher number of intensive care unit admissions compared with children who simply had a severe case of COVID-19 (74% vs 44%). Bear these data in mind as you continue to test patients of all ages.