Many parents have become quite alarmed by Multisystem Inflammatory Syndrome in Children (MIS-C), also known as “pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS)”. The media alerted us early in the epidemic to the small number of children who developed a hyperinflammatory state from the viral infection. While the vast majority of children suffered minimal effects from the virus, these few children endured multiple organ dysfunction, high fevers, abdominal pain, vomiting, diarrhea, rashes, mouth lesions, low blood pressure, and other cardiovascular challenges.
The condition resembles Kawasaki’s disease, a hyperinflammatory condition which occurs mostly in children under 5 years old and of Asian descent. Besides the fevers and multi-system involvement, they both have high rates of coronary artery aneurysms. However, MIS-C patients are generally over 7 years old and cross into multiple races. MIS-C patients also develop more complications in the neurologic system like headaches, mental status changes, cranial nerve palsies, seizures, and strokes. Up to 3.5 percent of MIS-C patients die of the condition.
Another interesting discovery about MIS-C centers around the fact that it does not occur during acute COVID disease for these children. Their acute infection tests are normal, but their antibodies to SARS-CoV2 are elevated. This suggests that the condition develops more from an aberrant immune reaction than the active infection.
Conventional medicine has performed decently well for these children. A treatment summarized in the paper as “Intravenous immunoglobulin, adjunctive glucocorticoids and low-dose aspirin until coronary arteries are confirmed normal at least 4 weeks after diagnosis” has helped many children recover. When the coronary arteries enlarge too much, blood thinners like warfarin or enoxaparin are added. These children are monitored closely with echocardiograms and EKGs along with MRI’s in certain situations.
Functional medicine may have further therapies to offer, but the very small number of children who actually contract this condition makes it impossible to speak beyond hypotheticals. We would add the natural and safe anti-inflammatories like vitamin C and glutathione at the very least. We would consider omega 3’s, curcumin, and vitamin E to lower inflammation further. Beyond that, we would look to optimize nutrition, as always, to help patients recover from acute illnesses.
Restoring healthier lives means that we apply what we do know to the developing situation as far as we can to remove the obstacles preventing our patients from enjoying family time, work productivity, exercise and life in general. Helping our children who suffer from MIS-C live a healthier life requires applying the wisdom of conventional and functional medicine.
Ani Nalbandian, Kartik Sehgal, Aakriti Gupta, Mahesh V. Madhavan, Claire McGroder, Jacob S. Stevens, Joshua R. Cook, Anna S. Nordvig, Daniel Shalev, Tejasav S. Sehrawat, Neha Ahluwalia, Behnood Bikdeli, Donald Dietz, Caroline Der-Nigoghossian, Nadia Liyanage-Don, Gregg F. Rosner, Elana J. Bernstein, Sumit Mohan, Akinpelumi A. Beckley, David S. Seres, Toni K. Choueiri, Nir Uriel, John C. Ausiello, Domenico Accili, Daniel E. Freedberg, Matthew Baldwin, Allan Schwartz, Daniel Brodie, Christine Kim Garcia, Mitchell S. V. Elkind, Jean M. Connors, John P. Bilezikian, Donald W. Landry, Elaine Y. Wan. Post-acute COVID-19 syndrome. Nature Medicine, 2021; DOI: 10.1038/s41591-021-01283-z
Thanks to Science Daily:
Columbia University Irving Medical Center. “Long-haul COVID: Physicians review what’s known.” ScienceDaily. ScienceDaily, 22 March 2021. <www.sciencedaily.com/releases/2021/03/210322175018.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.