In wake of omicron, CT sees rise in COVID-linked syndrome affecting children - Hartford Courant

Connecticut has seen a recent increase in multisystem inflammatory syndrome in children, a condition that can develop several weeks after a COVID-19 infection, hospital officials say.

“Last week alone we saw 10 admissions for MIS-C,” said Alex Hogan, a hospitalist at Connecticut Children’s Medical Center who treats patients with the condition. “Double the most the hospital had ever had.”

First detected in the spring of 2020, MIS-C is a condition in which vital organs can become inflamed, often causing severe illness and hospitalization. The syndrome can be deadly, though most patients eventually recover.

Physicians at local hospitals say they had been seeing MIS-C at relatively low levels until about late December, when patients began to show up in greater numbers.

The explanation for the uptick is this, Hogan said: MIS-C follows COVID-19. After a winter in which tens of thousands of Connecticut children tested positive for COVID-19, it was natural that MIS-C would show up at unprecedented levels.

“MIS-C waves happen two-to-six weeks after a huge spike in cases,” Hogan said. “It’s almost inevitable that if there’s a big spike in cases there’s going to be a big spike in MIS-C.”

MIS-C remains extremely rare, with about 110 cases recorded in Connecticut since the start of the pandemic, according to the Department of Public Health.

But in the wake of the omicron surge, the state has been seeing more cases in recent weeks that any other time since the condition was discovered.

At Yale New Haven Children’s Hospital, doctors saw only 19 cases of MIS-C from July through December, followed by 13 in January alone and four so far in February.

“In about six weeks we’ve seen about as many kids as we did for the previous six months,” Dr. Tom Murray, the hospital’s associate medical director for infection prevention said.

Though no MIS-C patients at Yale New Haven Children’s Hospital have died, Murray said, about 30% have required intensive care.

“There aren’t many infections that cause post-infectious complications like this that have the potential of putting you in the intensive care unit,” Murray said. “So 13 [in January] is a very large number.”

Dr. Juan Salazar, physician-in-chief at Connecticut Children’s, said there was initially some question whether the omicron variant would lead to MIS-C but that the answer was “unequivocally yes.”

“Some of those kids have been pretty sick,” said Salazar, who is conducting research on MIS-C. “Some of them have been in the ICU.”

Connecticut Children’s has also not seen any children die of MIS-C, Salazar said.

The good news, experts say, is that MIS-C almost never occurs in vaccinated children. At Connecticut Children’s, Salazar estimates that 98% of cases have come among children either too young to be vaccinated or whose parents have chosen not to vaccinate them.

“Some of them are slightly older kids who should have vaccinated months ago,” Salazar said. “Vaccines prevent this stuff, so it’s still frustrating that so many have not been vaccinated.”

Not only do vaccines make children less likely to get COVID-19, and therefore less likely to get MIS-C, they also block MIS-C specifically, Salazar said.

“The vaccinated kids who may still have breakthrough COVID don’t get MIS-C, or very rarely get MIS-C,” Salazar said.

Though all children age 5 and older have been eligible for vaccination since November, only 45% of Connecticut residents 5-11 had received at least one dose as of Thursday, by far the lowest of any age group according to state numbers.

Beyond vaccination, Hogan says, the best way to prevent outbreaks of MIS-C is to prevent transmission of COVID-19 among children.

“We should be doing everything we can to stop kids from getting COVID,” he said. “Because you don’t know which of the thousand kids who get COVID in the school are going to end up with MIS-C and which of those are going to end up in the ICU.”

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Symptoms of MIS-C can vary case-by-case, but the Centers for Disease Control and Prevention advises parents to look for prolonged fever plus some combination of stomach pain, bloodshot eyes, diarrhea, dizziness or lightheadedness, skin rash and vomiting. Hogan said rashes in particular are present in at least 70% of cases he sees.

Physicians say it can be difficult to predict which kids will develop MIS-C, which often occurs in patients who had relatively mild cases of COVID-19.

“If you have a child who’s got a persistent fever and abdominal pain or belly pain and a rash, they really should call their pediatrician and be evaluated,” Murray said.

Hospital officials say they expect to continue seeing MIS-C cases for several more weeks to come. With Connecticut now past the worst of its omicron-fueled surge, though, Salazar says he’s hopeful MIS-C will fade before long.

“I think we’ll still see patients over the next two weeks and then it will begin to go down” he said, “and hopefully this time go away.”

Alex Putterman can be reached at aputterman@courant.com.