UAE Reports cases of children exposed to Coronavirus with symptoms of a new disease

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As the number of coronavirus cases continues to dwindle in the UAE, a top doctor in the capital has cautioned parents about an unexplained hyperinflammatory syndrome in children.

Described as multisystem inflammatory syndrome in children (MIS-C), the paediatric condition is presenting in children who have recovered from COVID-19, or been exposed to people suffering from COVID-19, the doctor told Gulf News.

“Since the start of the pandemic, we have not seen children suffer from severe forms of COVID-19 and they very rarely require intensive care. However, over the past few weeks, there have been numerous reports from Europe and the United States of otherwise healthy children presenting with MIS-C after being exposed to COVID-19 in the preceding month,” said Dr Musaab Al Ramsi, division chief for the paediatric intensive care unit at Sheikh Khalifa Medical City (SKMC).

As the capital’s premier public hospital, SKMC has been treating patients with COVID-19 from the start of the outbreak.

Dr Al Ramsi said the hospital has seen five children, aged between six and 12 years, with MIS-C in the last three weeks.

He said symptoms to look out for include persistent high fever, congested eyes, red and crackled lips, skin rash, nausea and diarrhea. Because these symptoms can be confused with those of a common infection, a key differentiator is the high fever that is not adequately controlled with paracetamol, he noted.

“The fever lasts for more than three days, and is higher than 39 degrees Celsius. In addition, the disease is presenting in children who have either had COVID-19 three to four weeks earlier, or been exposed to it in some way,” the doctor clarified.

“Unlike Kawasaki disease, there is higher incidence of cardiac symptoms, including myocardial dysfunction and shock,” Dr Al Ramsi said.

Investigations via echocardiogram (ECG) showed that the children had cardiac symptoms and were suffering from low blood pressure. Doctors were able to confirm via antibody and serology tests that they had also had exposure to COVID-19 in the past month, he added.

“We immediately started treatment using a multidisciplinary approach, including intravenous immunoglobulin to confuse the immune system, corticosteroids to suppress the inflammation, and in severe cases, an immunomodulator named Anakinra. Some of the children also required mechanical ventilation and vasoactive medications due to shock and hypotension,” Dr Al Ramsi said.

Fortunately, all of the children after three to five days in paediatric intensive care, were transferred to the ward for further treatment.

“If a child has any manifestation of these symptoms [especially high fever, congested eyes and paleness], they should be brought to hospital for investigation and treatment. The sooner they are treated, the better the outcome will be. On the other hand, if there is a delay, children can develop fatal complications like coronary artery dilations and cardiac dysfunction,” Dr Al Ramsi warned.

“Awareness is important so that children are brought to the hospital early for treatment and proper care,” Dr Al Ramsi said.

MIS-C symptoms to look out for

Prolonged high fever

Congested eyes

Rash

Diarrhoea

Nausea

Paleness

Lethargy and fatigue