MIS-C surges 'almost predictable': expert

NEW YORK — Surges of multisystem inflammatory syndrome in children, or MIS-C, are “almost predictable,” according to an expert’s presentation.

Roberta DeBiasi, MD, MS, section chief of pediatric infectious diseases at Children's National Medical Center in Washington, D.C., gave the presentation on the first day of the 34th Annual Infectious Diseases in Children Symposium.

“We've now had three surges,” DeBiasi said, “and they always come about 4 to 6 weeks after we see the peak of our COVID-19.”

DeBiasi also reported that although COVID-19 cases at her hospital were on a decline, MIS-C cases were “trending up.”

“But what we're trying to do, we and many other centers [are] trying to figure out a signature — not only for MIS-C, but for specific types of MIS-C — so that you can target the best therapy to whatever MIS-C type that is,” she continued.

She added that a study of cytokines in blood during the first wave of MIS-C had given her fellow researchers a crucial answer.

“Most importantly, we wanted to know, was there something about the virus that made it more likely to get MIS-C vs. primary COVID?” DeBiasi said. “And the answer was no, it was equal representation of the versions of virus that were circulating at the time. So in our center, we really worked hard to have a cohort that can be followed over time and treated the same way over time, because that really adds to the data.”

The CDC’s case definition for MIS-C is any patient aged younger than 21 years who presents with fever, laboratory evidence of inflammation, evidence of clinically severe illness requiring hospitalization, with two or more organs involved, who has no alternative plausible diagnosis and has tested positive for current or recent SARS-CoV-2 infection, or reports exposure to a suspected or confirmed case of COVID-19.

DeBiasi said that long COVID following MIS-C is something that she, along with the NIH, are investigating in a long-term study, for which she serves as principal investigator.

“We are working with the NIH to enroll a large number of kids, because we have a large number at our center,” DeBiasi said. “We're aiming to get 1,000 kids that have either COVID-19 or MIS-C and then compare them to 1,000 healthy contacts either in their household or at college or wherever they were. We'll be following these kids for 3 years to see the effects, and we’re hoping to learn a lot over the next few years.”