Why are doctors preparing to confront this rare syndrome in children in light of the Corona virus?

Dubai, United Arab Emirates (CNN) -- After the omicron mutant set a record for the number of sick American children in January, children's hospitals in America were braced for the rare, but serious, cases seen with each new mutation that broke out during a pandemic. COVID-19 is known as pediatric multisystem inflammatory syndrome (MIS-C). However, a number of hospitals stated that this expected increase in these cases has not yet appeared.

Symptoms of pediatric multisystem inflammatory syndrome due to COVID-19 can appear several weeks after infection. It may cause inflammation of parts of the body, and affect major organs, such as the kidneys, brain, lungs, and heart.

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The symptoms of this rare and serious disease are not uniform, but may cause abdominal pain, vomiting, diarrhea, rash, conjunctivitis, and a drop in blood pressure. It always comes after a mild or asymptomatic illness caused by COVID-19.

But with Omicron causing so many diseases, it wasn't clear exactly how many CMS cases of COVID-19 could be expected by hospitals, or how severe they were.

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The US Centers for Disease Control and Control tracks cases of pediatric multisystem inflammatory syndrome from COVID-19, but updates the numbers once a month on its website. As of January 31, 6,851 cases have been reported during the pandemic, including 59 deaths.

This is a small part of the number of "Covid-19" cases recorded among children. More than 12.3 million children have been infected since the start of the pandemic, according to the American Academy of Pediatrics' analysis of hospitalization and mortality data by age from the states that report it.

The rapidly spreading "Omicron" mutant has caused a very large increase in the number of registered corona infections, which reached nearly 4.5 million children, since the beginning of January.

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Various regions in several US states are still experiencing omicron, and it will take some time before scientists get a clearer picture of why this mutant causes MSS in children in general.

The majority of cases of this disease did not lead to death, but the Wisconsin Department of Health Services reported last week that a 10-year-old had died last month as a result.

Tom Haupt, a respiratory epidemiologist at the Department of Health Services, said Friday that the state is prioritizing physicians to report cases of pediatric multisystem inflammatory syndrome due to "Covid-19", so that state officials can then notify the US Centers for Disease Control and Control. The CDC should do so as soon as possible.

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He explained: "We want this information with the US Centers for Disease Control and Control in the hope of knowing the cause of this disease syndrome and how to prevent it further."

There are many ongoing studies to show the causes of this disease in the United States of America, and why some children are affected by it and others do not, and scientists are seeking to know its long-term repercussions, and the best way to treat it.

“The only certainty is that CMS-caused by Covid always follows the same pattern,” said Dr. Roberta DiBiazzi, chief of infectious diseases at Children’s National Hospital in Washington, D.C., noting that “two to six weeks after a sudden outbreak of any A new mutant, we're looking for CMS infections, and we definitely find them."

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A study published on Monday revealed that during the winter of 2020-2021, there was one hospitalization with multiple system inflammation syndrome, for every hospitalization due to “Covid-19” among children aged 5 to 11 years. The period studied is much earlier than the Omicron wave, but the researchers note that "multiple systemic inflammation syndrome may not be as rare...as previously thought."

Dibiazi pointed out that the Washington Hospital, where she works, received 30 hospitalizations with this syndrome caused by "Omicron". She added that the number of cases decreased with each wave, pointing out that they treated 100 children during the first wave, and 60 during the spread of the "delta" mutant.

And she considered that the reason for the decrease in the number of cases is not clear, but it is likely that the vaccines that are licensed to be given to children aged 5 years and over may have helped in this.

She said, "Older children have much lower incidence of polysystemic inflammation at the moment, and this makes sense because they have received the vaccine, and there are many studies that show that vaccination reduces the risk of developing this syndrome and severe disease."

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Another study, published on Tuesday, found that the possibility of developing MSS occurred in only 1 in every million children who were vaccinated, a number "significantly lower" than previous estimates of 200 cases per million in unvaccinated people who contracted corona, the researchers said. .

What are the symptoms to watch for?

Pediatricians said that if children develop Covid-19, parents should monitor their symptoms of polymyositis syndrome, usually four to six weeks after infection. They may look similar to the symptoms of "Covid-19" or completely different. If the situation worsens, children need treatment.

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Treatment usually includes care that focuses on relieving symptoms and preventing complications, including intravenous fluids and antibiotics to reduce fever, maintain high blood pressure and clear up any potential bacterial infection.

Since children with MSS overreact to the immune system, doctors give the child a drug that suppresses the immune system. These medications may include steroids or intravenous immunoglobulin, a treatment for people who are deficient in antibodies.

Some children may also need help breathing, with ventilators or an ECMO machine.

Dr. Marianne Michaels at the University of Pittsburgh Medical Center in Pennsylvania, USA, noted in several studies of this syndrome that "Long-term follow-up will also be necessary to understand how children are doing in the long-term. It is also important to understand what is going on in terms of the system of Immunity, which has a long-term effect. Why would this happen in this case when another child was otherwise healthy before the virus? Why didn't they get a good result?"

Most children seem to recover well

And a study published in the Journal of the American Heart Association in January showed that the majority of children with multisegmental inflammatory syndrome due to “Covid-19” recover quickly within the first week of discharge from the hospital, and fully restore heart function within three months.

Doctors said that the best way to deal with this syndrome is not to infect children with "Covid-19" in the first place.

"It is a very serious and frightening condition, which we want to avoid and prevent at all costs," said Dr. Yanni Manning at Children's Hospital Medical Center in Cincinnati, Ohio, USA.

This means that all children must be vaccinated if they are eligible, noting that the vaccination rate among eligible children is the lowest.

There is no approved vaccine for children under five, but parents can protect them by making sure every adult around them is fully vaccinated.