Healio Rheumatology reports clinicians and researchers continue to debate the etiology and treatment paradigms of multi-inflammatory syndrome in children (MIS-C), which impacts some children with COVID-19, according to a presentation at the American College of Rheumatology (ACR) State-of-the-Art Clinical Symposium by Karen Brandt Onel, MD, chief of pediatric rheumatology at HSS. 

It is important to understand who may be impacted by MIS-C. Children aged 6-12 years are more likely than their younger counterparts than to develop this complication, as are children with cardiorespiratory or cardiovascular without respiratory involvement, those mucocutaneous infection, neutrophil or lymphocyte ratios greater than five and low platelet counts. It is most likely to occur in non-Hispanic Black children.

As for treatment, early research conducted by Dr. Onel and colleagues showed that intravenous immunoglobulin (IVIG), along with aspirin, administered before day 10 of infection, could be most effective. Dr. Onel advised it is key to intervene as early as possible. However, she acknowledged that this can often prove challenging, given that COVID-19 can be asymptomatic for a prolonged duration after infection. “For most children, including those under immunosuppressive medications, COVID-19 infections are mild and self-limiting,” she said. “A group of approximately 2500 in the United States have developed severe inflammatory disorder that must be treated aggressively.”

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