Multisystem inflammatory syndrome in children in South Africa
Multisystem inflammatory syndrome (MIS-C) has been reported in children with COVID-19. MIS-C is also known as paediatric inflammatory multisystem syndrome is temporally associated with severe acute respiratory syndrome coronavirus (PIMS-TS). “The definition of MIS-C issued by WHO includes clinical and laboratory features, with evidence of COVID-19, or likely contact with a person who has or has had COVID-19”.
South Africa has seen the highest number of COVID-19 cases in Africa, with the Western Cape Province acting as the “initial epicentre with a total of 93â414 people with confirmed COVID-19 by 31 July 2020, of whom 2910 were younger than 15 years old”.
The Cape Town MIS-C team summarised the first 23 cases of MIS-C treated at The Red Cross War Memorial Children's Hospital and the Tygerberg Children's Hospital both in Cape Town, South Africa, from 4 June to 24 July 2020.
“Most of this cohort had no confirmed or suspected infection or no contact with COVID-19 and no access to antibody tests, but all met clinical diagnostic criteria and had likely community contact with the disease”.
The Cape Town MIS-C Team describe their cohort and state that “a high level of suspicion is required during diagnosis because the presenting features of MIS-C were non-specific (persistent fever, rash, and abdominal pain)”. The researchers also stated that “all 23 children received intravenous immunoglobulin, with 15 (65%) children requiring additional drugs (such as methylprednisolone, a second intravenous immunoglobulin, or tocilizumab), all of which might not be universally available or affordable. Global data on the responses to therapy are urgently needed”.
The authors write that there are ongoing admissions of MIS-C to the hospitals and that even though the children are critically ill, all of them have survived with no discernible irreversible disease sequelae. The MIS-C team will be monitoring these children into the future.
Read the paper - Multisystem inflammatory syndrome in children in South Africa
Article by Bonamy Holtak