It was a few weeks before Christmas in 2020 when Alyssa Bendersky started worrying about her 6-year-old daughter, Paige. She had complained off and on about headaches and not feeling well for a few weeks, but she didn’t have a fever, and she didn’t test positive for COVID-19.
Then Paige became very ill. “She had a fever, and it wasn’t going down,” Bendersky said. “And she wasn’t eating or drinking.” She had Paige checked out by doctors and even had her tested for COVID-19, but nothing was clearly wrong.
Then her fever spiked to 105 degrees, her blood pressure dropped, and she was taken by ambulance from Aurora to Rush University Medical Center. She was going into shock.
Paige was experiencing multisystem inflammatory syndrome in children (MIS-C), a rare, serious, sometimes fatal illness that may develop after a child has been infected with SARS-CoV-2, even if there was no diagnosis and even if there were no symptoms. The syndrome itself can be hard to diagnose before it becomes serious because its early symptoms are vague and common.
“They didn’t know she had COVID, and then weeks later, Paige gets this very serious inflammatory response,” Logan said. “And the only reason we know she had COVID-19 is because she had antibodies against the virus.”
Paige was among a number of children treated for MIS-C at Rush’s pediatric intensive care unit last winter, weeks after COVID-19 cases in the Chicago area had risen sharply, according to Latania Logan, MD, MSPH, chief of pediatric infectious diseases at Rush University Medical Center.
More MIS-C cases likely
Now, COVID-19 is surging again, and this time, Rush is seeing more children with the virus, including more needing to be treated in the hospital, according to Logan.
"The vast majority of the children being hospitalized are under the age of 5, so ineligible for the vaccine, or are unvaccinated," Logan said, which underscores the need for those who are eligible for the vaccine and boosters to get them.
In the coming weeks, more children are likely to develop MIS-C, she said.
“We know when there's a wave of COVID-19, we can expect to see a wave of MIS-C about four to six weeks later,” Logan said in an interview with Scripps News Service.
MIS-C develops after acute COVID-19 infection, when the body launches an exaggerated inflammatory response that can affect blood vessels, the heart, lungs, gastrointestinal tract, kidneys — all of the major organs, she said.
At first, a child may experience vague symptoms, like fatigue or headaches, or symptoms commonly caused by other conditions, such as fever, rash, abdominal pain, diarrhea or vomiting.
“MIS-C looks like a lot of other things,” Logan said. But parents should pay attention if their child has symptoms, especially around four weeks after a confirmed or suspected case of COVID-19 or exposure to the virus. “If your child has fever, body aches, diarrhea or headaches, complains of not feeling well or doesn’t look well, you really want to be on top of this and check with their doctor.”
Symptoms can change suddenly
What can be especially concerning about MIS-C is that these symptoms can quickly change to become quite serious.
“Some of these children are in shock when we see them,” Logan said.
That was the case with Paige, who was suffering from an infection and dehydration when the inflammation appeared to be affecting her heart.
"Her heart rate was up, her blood pressure was low and her cardiac enzymes were elevated,” an indication that her heart may not have been getting enough oxygen, pediatric cardiologist Joshua Murphy, MD, told ABC 7 News Chicago. “She was very sick.”
After seven days of treatment at Rush University Children’s Hospital, six of them in intensive care, Paige’s symptoms subsided, and she went home.
While Paige continued to suffer occasional headaches for a few months, she, like most other MIS-C patients, recovered well, said Rush Copley Medical Center physician Megan Muscia, DO, who has been Paige’s pediatrician since her case of MIS-C.
“Now things look really good, and I wouldn’t know that she’d had it,” Muscia said.
'You should get the vaccine'
After seeing her daughter suffer such a serious illness, Bendersky made sure her children received a COVID-19 vaccine as soon as they became eligible in October.
“I don’t want a mom to go through what I went through,” Bendersky. “I remember just praying that she would make it."
Like her mother, Paige, now 7, is an advocate for the COVID-19 vaccine, as well as for following precautions.
“You should get the vaccine because I ended up in the hospital and my heart almost stopped,” she said, adding, “Keep your mask on and wash your hands.”
Learn more about the recent increase in COVID-19 cases in children and how to best protect them.