Is your little one also suffering from this strange illness after COVID-19? Let's talk about Multisystem Inflammatory Syndrome in Children (MIS-C)!

You've probably heard about the COVID-19 virus. We know that most of the time, when young children get it, it doesn't affect them as badly as it does adults. However, some children can develop more serious symptoms a few weeks after contracting COVID-19. That's what doctors call Multisystem Inflammatory Syndrome in Children , or MIS-C for short. Experts are still figuring out what it is and why it only happens to some children. But it's important to be aware of it.

What exactly is MIS-C, this medical condition?

Simply put, MIS-C is a condition in which multiple systems, or organs, in a child's body become inflamed at the same time. Think about it, when our body is fighting an infection, our immune system becomes overactive. Sometimes, after a COVID-19 infection, this immune system goes out of control and starts affecting different parts of the body. That's what mainly happens in MIS-C.

This is not something that comes on within two or three days of contracting COVID-19. It usually takes two to six weeks after contracting COVID-19 to develop these MIS-C symptoms. So, if your child has recently contracted COVID-19, or has been in close contact with someone who has COVID-19, it's a good idea to be a little vigilant about this.

What are the symptoms of MIS-C? How do we recognize it?

A child with MIS-C may have a variety of symptoms because they experience inflammation throughout their body. Not every child will have all of these symptoms, and the severity of symptoms can vary. However, there are some common symptoms that can be seen:

• Persistent fever: You may have a fever that doesn't go down for several days.
• Stomach upset: Symptoms may include severe stomach pain, nausea, vomiting, or diarrhea.
• Skin rash: Red, sometimes itchy, rashes may appear on various parts of the body.
• Redness and cracking of the lips: The lips may become dry, red, and possibly cracked. It's like saying "lips are burning."
• Red eyes: The whites of the eyes may become red and appear bloodshot. We say "bloodshot eyes."
• Swelling and redness of the hands and feet: The palms and soles of the feet may become red and swollen.

Just because you have one or two of these symptoms doesn't mean you have MIS-C. These symptoms can also be seen in other common illnesses. However, if your child has a persistent fever and more than one of these symptoms (for example, a fever with stomach pain and body aches), you should definitely see a doctor.

Symptoms that require urgent attention!

Sometimes the condition of children with MIS-C can worsen very quickly. Therefore, if your child shows any of the following warning signs , you should immediately take them to the Emergency Department (ETU) of the nearest hospital:

• If the child seems to be in a lot of pain, or appears excessively sleepy or confused.
• If you feel like you are having difficulty breathing, or if your breathing rate seems to be increasing.
• If you are talking about chest pain.
• If you have severe stomach pain.
• If your lips or face appear bluish (this means your body is not getting enough oxygen).

At this time, don't forget to tell the doctor if your child has recently had COVID-19 or has been in contact with someone who has COVID-19.

What other complications can occur due to MIS-C?

MIS-C is a condition that can affect one child differently than another. This inflammation in the body can damage various organs. The main effects may include:

• Heart: The heart muscle may become weak and heart function may be impaired.
• Blood cells and vessels: Blood clotting problems and inflammation of blood vessels can occur.
• Skin: Things like the damage we talked about earlier.
• Digestive system: Things like stomach pain and diarrhea can be severe.
• Eyes: Symptoms such as redness of the eyes.

Sometimes, this damage, especially to the heart, can have long-term effects. That's why it's important to recognize the disease early and start treatment.

How to accurately diagnose MIS-C disease?

The symptoms of MIS-C can be similar to those of other diseases. For example, conditions like Kawasaki disease or toxic shock syndrome can also cause similar symptoms. Therefore, if a doctor examines a child and suspects that they have MIS-C, they will do several tests to confirm the diagnosis.

What tests are being done for this?

The COVID-19 test is primarily used to determine whether the child has been infected with COVID-19 or has developed antibodies from a previous infection. In addition, tests are used to determine the extent of inflammation in the body and whether there is damage to various organs. These may include:

• Blood tests and urine tests: These can check many things, such as the level of inflammation in the body (inflammatory markers), the function of various organs, and the condition of blood cells.
• Chest X-ray: Check things like the condition of the lungs and the size of the heart.
• Special tests that examine the heart:
• ECG (electrocardiogram): This tests the electrical activity of the heart.
• Echocardiogram (ultrasound of the heart): This is like an ultrasound of the heart. It can check many important things like the structure of the heart, the function of the muscles, and the condition of the valves.
• Abdominal ultrasound: To check the condition of organs in the abdomen, such as the liver and spleen.

Assistance from specialist doctors

Because MIS-C is a complex condition, diagnosis and treatment often involve a team of specialists from different fields, not just one doctor. This team may include:

• Infectious disease specialists
• Cardiologists
• Rheumatology specialists
• Hematology specialists
• Critical care specialists

It is by combining the knowledge of all of these people that the best treatment for the child is decided.

How is MIS-C treated?

The treatment for MIS-C varies from child to child. It depends on the child's symptoms and test results. The main goals of treatment are to:

• Reducing inflammation in the body.
• Preventing blood from clotting unnecessarily.
• To protect the affected organ from further damage.

Doctors can use various treatment methods for this:

• Oxygen: If you are having difficulty breathing.
• Medicines: Medicines such as steroids to reduce inflammation, medicines called immunoglobulins (IVIG) to control the immune system, and medicines to prevent blood clotting may be given.
• Intravenous (IV) fluids: Things like saline are given if the body is dehydrated or if blood pressure is low.

If the condition of some children is serious, they may need to be admitted to the Intensive Care Unit (ICU) and treated under special observation.

Other important things to know

When talking about MIS-C, it's good to keep a few other things in mind.

Do I still need to take care after leaving the hospital?

Most children recover after treatment in the hospital. However, some children may develop long-term problems due to MIS-C. Therefore, it is important to continue to take care of your child according to your doctor's instructions even after you go home from the hospital.

For example:

• A child with MIS-C who has had some heart damage will need to continue seeing a cardiologist and have regular checkups. They may need to limit activities like exercise, running, and playing for a while. They will have to wait until the doctor says, "Okay, that's okay."
• If you continue to use medications such as steroids to reduce inflammation, you should consult a rheumatologist or endocrinologist to properly reduce or change the medication.

Therefore, it is very important to follow the instructions given by doctors exactly and take the child to the appropriate clinics.

The best way to prevent MIS-C

Actually, MIS-C is a very rare condition . However, because it can be serious, we should try to protect ourselves from it as much as possible. The best way to prevent MIS-C is to avoid getting infected with COVID-19.

• To that end, it is very important that everyone over the age of 6 months gets the COVID-19 vaccines and keeps them up to date . The new vaccines that are currently available provide protection against the most common COVID-19 variants .

Remember these things to protect yourself from common illnesses.

To prevent the spread of any disease, not just COVID-19, it's good for everyone to follow these simple health habits:

• Wash your hands often and thoroughly. Wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
• Avoid close contact with people who are sick. Avoid close contact with people who have symptoms such as fever, cough, and cold.
• Keep frequently touched surfaces clean. Wipe down doorknobs, counters, and phones regularly.
• Try to breathe as much fresh air as possible. If you're indoors, open the windows and let in some fresh air. It's also good to get outdoors.

Finally, finally, remember this (Take-Home Message)

Okay, so we've talked a lot about MIS-C. The important thing to remember is that this is a rare, but potentially serious condition. It's linked to COVID-19 infection.

If your child has a persistent fever and more than one of the other symptoms we've discussed (such as stomach ache, body aches, red eyes), don't waste time and seek medical advice immediately. The earlier you recognize and start treatment, the more likely your child will recover.

Don't panic, but be careful. Take the necessary steps to protect yourself from COVID-19. Wishing you and your family good health!

` MIS-C, COVID-19 Children, Multisystem Infection Syndrome, Pediatrics, Fever, Inflammation, Heart Disease