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Inflammatory reactions to COVID-19 in children

BC Children's Hospital is watching closely for a rare inflammatory reaction to COVID-19 in children.
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​The novel coronavirus, or COVID-19, has a very low infection rate in children. It's estimated to be between one and five per cent worldwide. 

Reports from Italy, the UK, and the United States have shown an increase in cases of multisystem inflammatory syndrome in children (MIS-C), and they have found that this is occurring several weeks after a COVID-19 infection. 

BC Children's Hospital as well as hospitals in Toronto and Montreal have seen children with similar symptoms. At this time, we have had no confirmed cases of MIS-C at BC Children's. 

As B.C. has seen much lower rates of COVID-19 infection than harder hit areas of the world, we are also less likely to see cases of MIS-C in our province at this time. BC Children's will continue to monitor closely any patients with symptoms that could be in keeping with MIS-C.   

MIS-C is a newly recognized clinical syndrome being reported in children and adolescents. Physicians believe this syndrome could be triggered by a response to the virus in some children because the cases are being recognized at the same time as the pandemic. 

MIS-C appears to be caused by an exaggerated immune response, leading to severe widespread inflammation. 

Different parts of the body can become inflamed, including the heart, gastrointestinal system, lungs, kidneys, brain, skin, eyes, and lymph nodes. It can be serious and even deadly, but most children get better with medical care. 

Some children are showing symptoms that are similar to other inflammatory or infectious conditions, such as Kawasaki disease or toxic shock syndrome, or symptoms that can be mistaken for appendicitis. 

Symptoms of MIS-C may include: 
  • persistent fever 
  • stomach pain and vomiting/diarrhea
  • rash or redness in fingers or toes
  • shortness of breath/or breathing problems
  • conjunctivitis
  • swollen lips, hands or feet

Tests for active COVID-19 infection in these children are most often negative. However antibody tests, which detect previous exposure to infection, have been positive in many of these initial international reports. Antibody testing is not currently available to the public in B.C.

Specialists at BC Children's are available to assess and provide advice for children possibly affected by this condition. We are working with provincial partners to ensure that information can be rapidly disseminated across B.C. for the benefit of all children in the province. We are also part of international working groups dedicated to MIS-C.

Parents who have concerns about their child's health should contact their family care provider or local urgent care centre. 

Take your child immediately to your nearest emergency department or call 911 if your child: 

  • Is having difficulty breathing
  • Has blue lips or skin, or appears very pale
  • Is coughing excessively, particularly with a fever
  • Is vomiting excessively, especially if there is blood in the vomit
  • Has diarrhea and vomiting, is not producing tears, and has not urinated for several hours
  • Has a high fever, appears very sleepy, and has not improved with acetominophen (Tylenol) or ibupfrofen (Advil).
  • Is under three months of age and has a fever of 38 degrees C (100.4 degrees F) or greater
  • Pain or pressure in the chest that does not go away
  • New confusion
  • Inability to wake or stay awake
  • Severe abdominal pain

For more information on COVID-19 and children, please visit our website.

BC Children's Hospital; COVID-19; MIS-C
Children's Health
SOURCE: Inflammatory reactions to COVID-19 in children ( )
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