Pediatricians worried about post COVID-19 complications in children 

After black fungus, the Multi-system Inflammatory Syndrome in Children (MIS-C) is the next cause of concern for the medical fraternity to deal with the post COVID-19 complications.

The syndrome involving multi-organ is usually seen weeks after the peak of COVID wave and can pose a threat to the children post infection. "I won't say it's (MIS-C) dangerous or life threatening but, of course, sometimes it affects children badly. It can affect organs like heart, liver and kidney in children.

It happens four weeks or six weeks after they had an infection," Dr Yogesh Kumar Gupta, pediatrician in Fortis Healthcare said. Gupta said the MIS-C is an outcome of reaction in the body against the antigen developed to counter the COVID-19. "Active COVID infection is not something we are worried about because most of them are mildly to moderately symptomatic but once they recover and once they have antibodies in them, then these antibodies are somehow reacting in children.

It's like an allergy or reaction in their body," the child specialist explained. According to Gupta, the MIS-C can affect organs like heart, liver and kidney in children as post COVID-19 complication and not as an active COVID-19 case. He also said that the MIS-C is a documented entity in other countries after the peak of COVID-19 was over. The doctor said there were three cases last year and this time again there were two cases in the Fortis Healthcare when the second wave hit the state. He expressed his fear about getting more MIS-C cases once the peak is over.

According to Dr Giridhara R Babu, epidemiologist at the Public Health Foundation of India and the State COVID-19 Technical Advisory Committee member, the hospital based prevalence is not the right parameter for population level parameter. "But that does not take away the importance of studying this (MIS-C). Even if it is a small percentage, this needs thorough investigation. A clear understanding is needed ahead of the next wave," Babu said.

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The reason to study the MIS-C prevalence is essential because Fortis like facilities are not available everywhere. "Preventing the infection among children is the most important aspect and next is to identify the symptoms as early as possible and refer to them for care by the specialists," Babu pointed out. Dr Gupta and Dr Babu were of the view that children must be protected from COVID-19 infection now and the best way is to vaccinate the eligible people at the earliest as possible. They also stressed upon developing a vaccine for children at the earliest for their safety.

According to official sources in the Karnataka COVID-19 War Room, the state saw 20,206 COVID-19 infections including 17 fatalities among children below 10 years of age from March 1 to May 15 this year when the second wave hit the state. The case fatality rate, however, among children is only 0.1 per cent.