As per the report of the Union ministry of Health and Family Welfare on September 8, 2020, cases of an uncommon but potentially fatal multisystem inflammatory syndrome (MIS-C) are being reported in India after being observed in Italy, Spain, the UK and the US. Though Covid-19 infection is often mild or asymptomatic in children, and rarely causes death but such emergence is a major cause of concern. A rarity in India, MIS-C is marked by high fever, organ dysfunction, and strongly elevated markers of inflammation, with many symptoms overlapping with those of the Kawasaki disease, which leads to inflammation of the arteries (vasculitis), autoimmune dysfunction, encephalitis (swelling of the membranes surrounding the brain), cardiovascular shock, and multiple organ failure.

As per researchers, a systems-level analysis of immune cells showed that multiple autoantibodies (immune proteins that mistakenly target a person’s own tissues or organs) and cytokines (proteins that regulate immunity and inflammation) were involved in triggering MIS-C. Fever, conjunctivitis, swelling in the foot, swollen lymph nodes (throat) and rash are common in both Kawasaki and MIS-C. But, headache, abdominal pain, vomiting, sore throat, and cough were more common in MIS-C. It was also found in the study that MISC-C was marked with elevated levels of two cytokines, IL-10 and TNF alpha, which were not or minimally elevated in children with mild to severe Covid-19 while in case of Kawasaki disease, there were mild elevations of other cytokines and not IL-10.

The findings support an earlier study which stated that MIS-C is a post-viral hyper-inflammatory reaction to Sar-Cov-2, the virus that causes Covid-19, and was related to but different from Covid-19 and Kawasaki syndrome.

Children have a strong innate immune response due to trained immunity because of frequent viral infections and vaccinations such as BCG. Children are also less likely to have risk factors and co-morbidities, which raises risk of complications associated with Covid-19.

Courtesy: Hindustan Times

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