Virus leading to heart inflammation among children
SEVERAL heart inflammation complications are being observed in children hospitalised locally for COVID-19.
The complications, however, are said to be rare side effects caused by the virus.
Dr Tracy Evans Gilbert, consultant in paediatrics, tropical medicine and public health at Cornwall Regional Hospital, told the Jamaica Observer that a survey of children admitted for COVID-19 was conducted between September 2020 and May 2021 by a team of paediatricians, who reviewed 181 cases of COVID-19-related admissions among seven hospitals for children 0-17 years.
Of the 181 children, which represented most but not all admissions during that time period, 28 had multi-system inflammatory syndrome in children (MIS-C), 13 of the 28 had involvement of the heart and 11 required intensive care unit (ICU) management.
Dr Evans Gilbert told the Sunday Observer that among the 13 children with heart involvement, there was evidence of inflammation of the heart muscle — myocarditis; inflammation of the lining surrounding the heart — pericarditis; inflammation of the valves — valvulitis, swelling of the heart vessel or a combination of all four.
The consultant paediatrician added that symptoms of MIS-C, which most times showed up weeks after COVID-19 infection, include fever and a combination of rash, red eyes, feeling extra tired, vomiting or diarrhoea, chest discomfort or pain, shortness of breath, headache, low blood pressure.
She also highlighted that symptoms of myocarditis/pericarditis are chest pain, shortness of breath, feelings of having a fast beating, fluttering, or pounding heart.
There were no fatalities and Dr Evans Gilbert mentioned that all 28 children were discharged well and those with heart involvement were followed up by a cardiologist as the heart involvement had either resolved or was resolving at the time of data collection.
Last Tuesday, Dr Melody Ennis, director of Family Health Services in the Ministry of Health and Wellness, told a virtual vaccination town hall held with the Ministry of Education, Youth and Information that the rare side effect of myocarditis and pericarditis was also observed among 674 people, mostly boys, between the ages of 16 and 30 who received the Pfizer vaccine. She said to date there are no deaths from the 674 and the vast majority resolved with bed rest, fluids and treating of symptoms.
Dr Ennis stressed that the reaction to the vaccine and the complications as a result of COVID-19 infection are rare.
Further, Dr Evans Gilbert said the local experience reflects what was seen in the United Kingdom and United States and the majority of people affected recover.
“MIS-C is a rare complication of SARS-COV-2 (COVID-19) infection. The majority who had initial severe illness in the UK, for example, when followed for six months had completely resolved,” she told the Sunday Observer.
Moreover, Dr Evans Gilbert said children are still considered low risk for infection, but low risk does not mean no risk, especially since the highly transmissible Delta variant has been causing a spike in cases attributed to the third wave of COVID-19 infections.
“In the US there have been an increase in the number of children infected and hospitalised due to COVID-19 since the Delta variant began circulating. There have been 3,741 cases of children 0-9 and 5,374 [cases of children] 10-19 [with COVID-19 in Jamaica]. Three children have died in the 0-9 and seven in the 10-19 years age group, usually with comorbidity. The mortality figures are consistent with low risk of death among children,” she said.
The consultant paediatrician added that they expect to see more cases of MIS-C after the surge.
“The increased number in children is thought to be due to increased infectiousness of the Delta variant. Additionally, the mask mandate had been relaxed in the US, but the surge of cases is being seen globally, After a surge of cases we expect to see more cases of MIS-C so we are monitoring for that and parents and doctors should be too,” she said.
Dr Evans Gilbert encouraged parents to get their children vaccinated, once they are eligible.
“The big picture is definitely to have as many people who are eligible for vaccination to get vaccinated. Children under 12 are ineligible. It is not yet clear what impact these new variants will have on children so we have to use all the tools we have at our disposal. The less circulation, the lesser the likelihood of new variants emerging,” she said.
“Keep healthy, wear masks, have clean hands, open the windows and keep a safe distance, vaccinate,” Dr Evans Gilbert added.