As the number of Omicron cases declines, doctors are worried about the potential for a surge in dangerous child complications.

After a record number of US children became ill in January with a variant of the Omicron coronavirus, children’s hospitals across the United States prepared for the accompaniment of every other Covid-19 pandemic surge. Pediatric multisystem inflammatory syndrome, Commonly known as MIS-C. However, many hospitals have stated that the expected surge in cases has not appeared-at least not yet.

MIS-C can track Covid-19 even weeks after infection. Parts of the body can become inflamed and affect major organs such as the kidneys, brain, lungs, and heart.

Symptoms of MIS-C It is not uniform, but may be accompanied by abdominal pain, vomiting, diarrhea, rash, conjunctivitis, and hypotension. It often follows mild or asymptomatic cases of Covid-19.

Since the Omicron variants cause so many illnesses, it was not clear what hospitals could expect to see MIS-C cases and how serious they were. Research is still underway, but many major children’s hospital care providers describe the results as “mixed bags.”

Cases seem to vary by region

The Centers for Disease Control and Prevention It tracks cases of MIS-C, but its website number is updated only once a month. As of January 31, 6,851 cases were reported during the pandemic, with 59 deaths.

This is just a small part of the child Covid case. Since the beginning of the pandemic, more than 12.3 million children have been infected with Covid. American Academy of Pediatrics Analysis of data from states reporting age-specific cases, hospitalizations and deaths.

More contagious Omicron variant Brought a flood of incidents: Since the beginning of January, nearly 4.5 million children have Covid.

Different parts of the country are still at different points in the Omicron wave, and it will take some time for scientists to better understand what this mutation means for the entire case of MIS-C. ..

Most MIS-C cases were not fatal, but last week the Wisconsin Department of Health reported that a 10-year-old child in the southeastern part of the state had died of MIS-C within the past month. ..

Tom Haupt, epidemiologist of respiratory illness Department, The state said Friday that it would prioritize having doctors report even suspected cases of MIS-C and allow state authorities to report to the CDC as quickly as possible.

“I would like to share this information with the CDC, but I hope we can find out what is ultimately causing it and what we can do to further prevent MIS-C,” Haupt said. I am.

There are several MIS-Cs Ongoing research Nationwide. Scientists are trying to figure out why some kids get it and others don’t. They are also trying to understand the long-term consequences and the best ways to treat them.

There is one thing that is certain about MIS-C. It “always follows the same pattern,” said Dr. Roberta DeBiasi, director of the Infectious Diseases Department at the National Hospital for Children in Washington, DC. “It’s always 2-6 weeks after it sees spikes from any variant, then we’re looking for MIS-C, and certainly it’s coming.”

DeBiasi is still one of several scientists Participant registration With MIS-C the study. From her work with children and Covid-19 to date, MIS-C still appears to be rare compared to the number of cases of Covid-19 treated by Children’s National doctors.

During the winter of 2020-21, there was one MIS-C admission for every Covid-19 admission for children aged 5 to 11 years, according to a study published on Monday. The period investigated was long before the Omicron wave hit, Researchers are careful “The MIS-C may not be as unusual as previously thought …”

In Washington, DeBiasi said there were 30 Omicron-related MIS-C cases in her hospital. But each wave has brought less cases with it. According to DeBiasi, in the first wave, about 100 children were treated with MIS-C and about 60 in Delta.

It’s unclear exactly why the number of cases has decreased, but she theorizes that the vaccine (currently licensed for children over the age of 5) may have helped.

“Currently, it makes sense because older children make up much less of MIS-C cases and are vaccinated. Just as vaccination reduces risk, MIS-C. There are many studies showing that it reduces the risk of cases of hospitalization and severe illness, “she said.

For example, CDC research Released in January The Pfizer / BioNTech Covid-19 vaccine has been shown to reduce the likelihood of MIS-C by 91% in children aged 12-18 years during the period when the delta mutation was predominant.

another study, MIS-C occurred in only 1 in 1 million vaccinated children, and an earlier estimate of 200 cases per 1 million unvaccinated people who captured Covid, announced Tuesday. Is a “substantially less” number than.

At Colorado Children’s Hospital, workers see about a few MIS-Cs a week, even though Dr. Pei-Ni Jone described them as “tons” of Covid-19 cases. She said that some of the MIS-C patients were vaccinated, but the majority were not.

“Children of MIS-C, we thought we might see an increase in Omicron, but it wasn’t. It’s very similar to us in Delta Surge,” said a cardiologist. .. “It’s really unclear what is causing the MIS-C case.”

At the University of Pittsburgh Medical Center, Dr. Marian Michaels saw with deep concern the many-fold increase in Covid infections and hospitalizations in her area, but the surge in MIS-C cases has not come. “Fortunately, we haven’t seen a surge in our area,” she said. “I appreciate it very much.”

Michaels regularly talks with other doctors as part of the CDC surveillance network and said that Omicron is a “mixed bag.” The number of cases of MIS-C is increasing rapidly in some hospitals, but only a handful are seen in many hospitals.

At the children’s hospital in Los Angeles, they also keep an eye on the number of patients, but so far they have been very good.

“Los Angeles Children’s Hospital has seen a significant surge in MIS-C cases following a surge in Omicron cases in the community,” Dr. Jacqueline Suzumas Zovik, a pediatric cardiologist at the Heart Institute of the Los Angeles Children’s Hospital, emailed CNN. I haven’t seen it yet. “

In December and January, the hospital treated 22 MIS-C patients. In February, I was hospitalized twice, three times.

“We know that MIS-C can begin weeks after a child is infected with SARS-CoV-2, so we continue to be vigilant and what the next few weeks will bring. I’m watching over you, “said Szmuszkovicz.

At the Lully Children’s Hospital in Chicago, Dr. Ami Patel, a pediatric infectious disease doctor, said workers have seen a steady increase in MIS-C cases since the end of December. But this is “a relatively small number overall, compared to the 2020 winter surge,” she said. During the Delta Serge, the hospital saw a “relatively small number” of MIS-C cases.

But at Seattle Children’s, it’s skyrocketing. “Approximately 15% of all MIS-C cases seen since March 2020 have occurred since mid-December 2021, when Omicron emerged as the major subspecies. These figures are for MIS-C. It suggests that is increasing with Omicrons, “Portman, director of research at Dr. Michael’s Department of Cardiology, emailed CNN.

The Texas Children’s Hospital in Houston peaked in the Omicron case on January 7, a little later than the rest of the world, so workers there still know what the load on the MIS-C case will be. not.

According to hospital pathologist Dr. Jim Versalovich, there was no “dramatic increase.” At least not yet.

Health providers there have treated more than 280 MIS-C cases since the pandemic began, two-thirds serious enough to require critical care.

The maximum number of MIS-C cases occurred between mid-September and mid-October, with the delta type occurring. “We haven’t reached that level yet,” Versalovic said. Instead, there are about 1 case per day every 2-3 days.

At Cleveland’s UH Rainbow Babys and Children’s Hospital, cases of MIS-C appear to have been followed much more quickly after a surge in Omicron infections than previous Covid-19 waves. But it may not have been unique to the Omicron variant, so pediatric infectious disease expert Dr. Claudia Hoyen said.

“I think the reason it looks so bad is because we were in a delta surge when Omicron came,” she said.

At the Cincinnati Children’s Hospital Medical Center, Dr. Patty Manning said workers saw a few MIS-Cs a week during Omicron. .. “

She said it may be due to successful vaccination, or something specific to Omicron may be reducing the number of cases of MIS-C. “Unknown at this point, but we never want to be comfortable,” Manning said. “Parents still need to be vigilant.”

Things to note with MIS-C

According to pediatricians, if a child is infected with Covid-19, parents should usually be aware of the symptoms of MIS-C 4-6 weeks after infection. They may appear to be a recurrence of Covid symptoms, or they may be completely different. If symptoms worsen, treatment is needed.

“The children died in the United States because they didn’t arrive in the emergency room fast enough,” Versalovic said.

The doctor said he learned a lot about the treatment of MIS-C. At Jones Hospital in Colorado, many MIS-C children did not need to be hospitalized as long as they were in the early stages of the pandemic.

According to UPMC’s Michaels, doctors are far better at MIS-C recognition. “It was important to treat in advance.”

Or process It usually includes care focused on symptom relief and prevention of complications. This includes infusions and antibiotics to control fever, maintain blood pressure, and eliminate the possibility of bacterial infections.

Because MIS-C can throw a child’s immune system into hyperdrive, doctors may also give the child a drug that suppresses the immune system.Those drugs include steroids Intravenous immunoglobulinA cure for people with antibody deficiency.

Some children may also need respiratory and cardiac support such as ventilation and ECMO treatment.

“Long-term follow-up is also essential to understanding how children behave in the long run and what is happening in terms of the immune system,” says some MISs. -Michaels, who is involved in the C study, said. “From an immune system perspective, it’s also important to understand what’s still having long-term effects. Why in that case, why they are compared to another child who was completely healthy before the virus? Don’t you have something like that? Is it a good result? “

Most children seem to be recovering well

Joan said that Colorado Children’s lenses seem to improve most children and have no protracted effect.

“The first MIS-C kids we saw were May 2020. So they have already had one follow-up and all the kids in 2020 did very well. “I am,” said Jone.

A studyA January journal of the American Heart Association suggested that most children with MIS-C began to recover in the first week after discharge, with full recovery of cardiac function within 3 months.

According to doctors, MIS-C’s best approach is to prevent children from becoming infected with Covid-19 in the first place.

“It’s a very scary and serious situation,” Manning said. “We absolutely want to avoid it and prevent it.”

This means that if you qualify, you should vaccinate all your children. Children are still the least vaccinated of the eligible age group.

There is no licensed vaccine for children under the age of 5, but parents can protect their children by making sure that all adults around them are fully vaccinated.

“We need to be vaccinated. There is no infectious disease in the world that has ever disappeared just because we have herd immunity from a natural illness. Michaels said. “It’s really important to be immunized and protect yourself and your loved ones.”

The-CNN-Wire

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