Rare COVID-19 complication in kids produces first fatality in Wisconsin

A rare but serious COVID-19 complication in children has resulted in one death, underscoring the continued importance of vaccines to curb the pandemic, according to state health officials.

The condition, multisystem inflammatory syndrome in children (MIS-C), causes inflammation in the heart, lungs, kidneys, brain and other organs, It can be found in people younger than 20, but it most commonly affects children ages 3 to 12, according to the state Department of Health Services (DHS).

On Friday, DHS reported the first known death from MIS-C in the state. The child was younger than 10, but DHS said other demographic details would not be released to protect the family’s privacy. At least 183 children in Wisconsin have been diagnosed with the condition over the course of the pandemic.

“It’s not common, but it’s common enough, and these kids are very sick,” said Dr. Greg Demuri, a pediatric infectious disease physician with UW Health Kids, in an interview Friday.

Demuri said there have been about 30 to 40 children treated for MIS-C at the UW Health American Family Children’s Hospital.

“Many of them are in the ICU and need critical care and a lot of very, very close monitoring,” Demuri said.

The syndrome typically appears from two to six weeks after a child has been exposed to the novel coronavirus responsible for COVID-19, said Tom Haupt, a DHS respiratory disease epidemiologist who spoke with reporters in a virtual briefing on Friday.

For many children with MIS-C, the initial COVID-19 infection was asymptomatic.

“A lot of times we’re seeing this in somebody who doesn’t know they’ve had COVID until we do the antibody test to prove it,” Demuri said.

Symptoms of the inflammatory syndrome include a lingering fever that does not respond to fever-reducing medicines such as Tylenol. Other signs include abdominal pain, persistent chest pain, difficulty breathing, inability to stay awake, confusion and failure to be alert, Haupt said. A bluish tinge in the lips and face is another sign.

The illness is identified after a hospital or emergency room visit and tests that identify the inflammation in the organs where it takes place.

Treatment for the condition includes blood thinners, steroids and immunoglobulin, Haupt said. About 60% of the children who have been diagnosed have been placed in pediatric intensive care.

“The best way to prevent this is through vaccination for anyone over 5 years old,” Haupt said. For children younger than 5 not yet eligible for a COVID-19 vaccine, he added, the rest of the family and friends should get vaccinated to reduce the chance of exposing the unvaccinated child.

Haupt said researchers have not identified a direct connection between MIS-C and so-called Long Covid, the name clinicians have given to a collection of symptoms in some COVID-19 survivors that linger for months or more after they were infected.

MIS-C can have its own set of long-term consequences, however. The syndrome can cause damage to the arteries of the heart and can sometimes produce a heart attack or lead to inflammation of the heart muscle and blood vessels, Demuri said.

“So these kids take a lot longer to recover,” Demuri said. “And we, as of yet, don’t know the long-term consequences on the heart — what happens when these kids get to be 20, 30 or 40.”