A new study shows post-Covid-19 effects in children

Hyperaxion June 27, 2020 9:27 pm

The study analyzes cases of Multisystem Inflammatory Syndrome in Children (MIS-C), a condition developed by children and adolescents who had Covid-19.

New research published in the scientific journal Radiology looks at Multisystem Inflammatory Syndrome in Children (MIS-C), a condition that has emerged in children who have had Covid-19. MIS-C is also known as Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS).

A new study shows post-Covid-19 effects in children
Radiography of a 15-year-old girl with Multisystem Inflammatory Syndrome: in the image on the left (a), there is a thickening of the bronchial wall of the lungs. The image on the right (b), taken three days after the first image, already shows significant opacification. (Credit: Radiological Society of North America).

Conducted by the Radiological Society of North America, United States, the study found that patients with the syndrome had airway inflammation and developed pulmonary edema rapidly, in addition to having coronary artery aneurysms and major intra-abdominal inflammatory changes. Laboratory tests found similarities between the new syndrome and Kawasaki disease, which also causes inflammation of blood vessel walls.

The Evelina London Children’s Hospital, in the United Kingdom, admitted several children with multisystem inflammatory syndrome in April 2020. The patients had several symptoms: fever, headaches, abdominal pain, rashes, and even conjunctivitis.

In addition to reviewing clinical and laboratory documents, the researchers analyzed the x-ray images of the first 35 children and adolescents up to 17 years old who were admitted to the pediatric hospital with suspected MIS-C between April and May 2020. Their average age was 11 years, and the majority were boys: 27 out of 35 patients.

From these data, the scientists realized that the most common symptom was fever, which appeared in 33 of the 35 cases studied. In addition, 30 children had gastrointestinal symptoms, such as abdominal pain, vomiting, and diarrhea. Skin rashes and conjunctivitis were the least common symptoms: the first appeared in 13 children and the second in 9.

Chest CT scan of a 15-year-old patient shows opacification - Multisystem Inflammatory Syndrome in Children affects the heart and lungs.
Chest CT scan of a 15-year-old patient shows opacification – Multisystem Inflammatory Syndrome in Children affects the heart and lungs. (Credit: Radiological Society of North America).

Among the 35 patients, 19 had abnormal x-ray scans. The researchers noted that the bronchial wall of the lungs was thicker. And in many of the chest CT scans, scientists also noticed that there was a buildup of fluid in the outer membranes of the lungs.

Most of the cases analyzed by the study were very serious. Of the 35 children, 24 had to be admitted to the Intensive Care Unit (ICU), seven of whom had to use mechanical ventilation and 20 needed inotropic support to help their heart beat correctly. In addition, two children even needed extracorporeal membrane oxygenation (ECMO), a technique that maintains blood circulation in patients with cardiovascular or respiratory failure.

CT scan of a 15-year-old male who had fever, sepsis, and shock with impaired cardiac function.
CT scan of a 15-year-old male who had fever, sepsis, and shock with impaired cardiac function. (Credit: Radiological Society of North America).

Based on the findings, the study authors recommend that research with even more patients with MIS-C should be done. “As pediatric radiologists, we were interested in the emerging pattern of imaging findings that we observed in these children,” said Hameed Heba Elbaaly, a doctor who helped with the study, in a statement. “Our intention is to bring these findings to the attention of the wider radiological community.”

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