Thread by @keithppereira

Vectors or Vulnerable?

#Covid_19…the more you know…🤦‍♀️🤷‍♂️

What we know about MIS-C in children so far : Evidence, CDC alert and more…

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Minimal medical burden

Low incidence: 1.7-2%

Asymptomatic or mild symptoms, however can pass this virus onto high risk population (vectors)

Severe illness: rare, can occur with pre-existing medical conditions, but have better outcomes (compared to adults)

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Late April

UK reports 8 children “Hyperinflammatory syndrome, multiorgan involvement-Kawasaki-like disease(KLD) and Shock”

Previously asymptomatic,healthy
Older ~ 7.5 yr
All Shock, 1 coronary art aneurysm,1 dies of cerebral infarct
NO cough/significant respiratory issue

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Superb infographic from Dr Rob Parker @redwings54 with excellent comparison between KD/KD like syndrome and COVID inflammatory syndrome

https://twitter.com/redwings54/status/1258129871303323649?s=20

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So, is this KD/KLD-like-disease related to #COVID_19 at all?

A @TheLancet publication from Bergamo, Italy, an epicenter for COVID in Italy reports a 'cluster' of cases, 30 x increased incidence and severity of KLD suggesting a temporal association

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-Starting point few weeks after 1st case of COVID
-2/10 +ve PCR (low viral replication), BUT 8/10 +ve antibody test

Recognition of this, late in the pandemic might reflect a mechanism for MIS-C - a post-infectious inflammatory syndrome, antibody or immune-complex mediated

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Understanding the inflammatory phenomenon in children with MIS-C may provide valuable information about immune protection for adults and children and if this is an antibody-mediated phenomenon, there might be implications for vaccine studies

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Where are we now with MIS-C?

🇺🇸~100 cases in NY besides 19 others states (3 deaths)
Children: ages of 5 -9 (29%) and between 10-14 (28%) years old

🇮🇹🇫🇷🏴󠁧󠁢󠁥󠁮󠁧󠁿~ 50 cases reported in Europe (~ 1 death)

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What to expect?

An 📈 in 4-6 wks from peak in your area

Parents:
Don’t panic, Be vigilant

Good news:
MIS-C is rare, most kids are responsive to intensive care
Prevention is the best cure (Face covering >2,hand hygiene and distancing)

Report to your doctor if you see 👇

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References

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Tagging

@AgnesSolberg @Daryl_Goldman @olgabrook @IRadPatwary @iRadRock @ibrahim_Gh @DrKaloo @GoaGmc @sayfuturemed @ne2r2d2 @KTamirisaMD @dfwmaclean @IRDocFuji @IR_SchwartzMD @skohoro @TSuperheroine @TheRealDoctorOs @lahinchman @pj_rochon @EnioMDMPH @chrisprener @CJJonesMD