• Steven Reinberg
• Posted February 3, 2022

Kids With COVID-Linked MIS-C Have Long-Term Symptoms

Following a bout of severe COVID-19, some children suffer lasting neurological complications, part of a rare condition called multisystem inflammatory syndrome in children (MIS-C), a new study finds.

The neurological symptoms are wide-ranging, and can include headaches, difficulty falling and staying asleep, daytime sleepiness, brain fog, attention difficulties, social problems, anxiety and depression, all of which can persist for weeks to months.

"I see this happen to 10% to 20% of children who have COVID," said senior researcher Dr. Sanjeev Kothare, director of the division of pediatric neurology at Northwell Health's Cohen Children's Medical Center in Lake Success, N.Y.

MIS-C often goes unrecognized, and no specific treatment for it exists, Kothare said. Children are typically treated for specific symptoms and the problems usually go away, but it can take time, he noted.

The best way to prevent your child from developing MIS-C is to have your child vaccinated against COVID-19, Kothare advised.

If, however, your child does develop MIS-C, he recommends that parents should "look out for these symptoms, and if they are present, discuss those symptoms with your provider so that they can give you adequate advice for treatment and decrease the symptoms faster."

For the small study, Kothare and his colleagues reviewed the cases of 47 children hospitalized for COVID-19.

Among these children, 77% had neurological symptoms, 60% had psychiatric symptoms and 77% had sleep symptoms while hospitalized. Before being hospitalized, 15% of the children had neurological symptoms, none had psychiatric symptoms and 7% had sleep problems.

Twenty to 26 weeks after leaving the hospital, 50% of the children who had neurological symptoms while hospitalized continued to have them. Also, 57% of the children who suffered psychiatric problems continued to have them after leaving the hospital, as did 42% of those who had sleep problems, the researchers found.

All of these problems were more likely to occur in children whose case of COVID-19 was so severe that they had to spend time in the intensive care unit (ICU), the study authors noted.

The report was published online Jan. 24 in the Journal of Child Neurology.

Jodi Mindell, associate director of the Sleep Center at Children's Hospital of Philadelphia, said, "As expected, sleep issues were very common during hospitalization. But what was most striking was the finding that one-third of the children continued to have sleep issues months later."

Mindell suggested that "parents whose children are continuing to have sleep issues should talk to their child's primary care provider or seek help from a sleep specialist. Some things that can help to get sleep back on track include sticking to a regular sleep schedule on weekdays and weekends, not napping during the day, and avoiding anything that is alerting in the middle of the night, such as screen time."

It's not clear why COVID-19 causes MIS-C, but it can be serious, even deadly. Thankfully, most children diagnosed with this condition get better, according to the U.S. Centers for Disease Control and Prevention.

In addition to mental problems, MIS-C can cause inflammation in different parts of the body, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

Dr. Guliz Erdem, a pediatric infectious disease physician at Nationwide Children's Hospital in Ohio, said that just being in intensive care may trigger many of the problems associated with MIS-C.

These kids go from being healthy to the ICU, and sometimes getting prolonged hospitalizations and multiple treatments, she explained. "They end up in the ICU, so they are very worried, there is that feeling that the end is near. So being in the ICU is a stressor in itself," Erdem said.

"Also, recovering from the ICU is a hardship even if you end up in ICU for a day or so," she added. "Your whole metabolism, your nutrition, everything is kind of upside down. Some kids do spend days in ICU with attached monitors and everything, so that ends with an already anxious child, intensifying that anxiety or depression."

For those children whose symptoms persist when they go home, Erdem advises letting them ease back into a regular routine and giving them the time needed to get back to normal.

Erdem stressed that the best protection is being vaccinated against COVID-19. "Having the vaccine is more effective than not having it. Even if you can still get the illness, it is not as severe in the majority of cases," she said.

More information

For more on MIS-C and COVID-19, head to the U.S. Centers for Disease Control and Prevention.

SOURCES: Sanjeev Kothare, MD, director, division of pediatric neurology, Northwell Health's Cohen Children's Medical Center, Lake Success, N.Y.; Guliz Erdem, MD, pediatric infectious disease physician, Nationwide Children's Hospital, Columbus, Ohio; Jodi Mindell, PhD, associate director, Sleep Center, Children's Hospital of Philadelphia; Journal of Child Neurology, Jan. 24, 2022, online