MIS-C (Multisystem Inflammatory Syndrome in Children) Care Options

Symptoms:

Persistent Fever: A fever lasting more than 24 hours is one of the hallmark symptoms of MIS-C.

Rash: Redness or swelling on the skin, sometimes accompanied by peeling, particularly on the hands or feet.

Gastrointestinal Issues: Vomiting, diarrhea, or abdominal pain may occur in children with MIS-C.

Fatigue and Lethargy: Children may appear excessively tired, irritable, or have low energy levels.

Swelling or Redness: Swollen hands, feet, or lips, along with redness in the eyes (conjunctivitis), are common symptoms.

Difficulty Breathing: In severe cases, respiratory issues can occur due to inflammation or fluid buildup.

Cardiac Symptoms: Chest pain, rapid heartbeat, or low blood pressure may indicate inflammation of the heart or blood vessels.

Common Causes of MIS-C:

MIS-C is a rare but serious condition that typically develops several weeks after a COVID-19 infection or exposure. It is caused by an excessive immune response leading to widespread inflammation in multiple organ systems.

Overactive Immune Response: The body’s immune system may overreact after a COVID-19 infection, leading to inflammation in organs such as the heart, lungs, kidneys, brain, skin, and eyes.

Cardiovascular Involvement: Many cases involve inflammation of the heart or blood vessels, which can lead to serious complications if untreated.

Self-Care Options for MIS-C:

MIS-C requires medical intervention and cannot be managed solely at home. However, parents can take steps to monitor and support their child’s recovery alongside professional care:

Monitor Symptoms: Keep track of fever, rash, and other symptoms. Note any worsening or new signs, such as difficulty breathing or extreme fatigue.

Hydration and Nutrition: Ensure the child stays hydrated and eats a balanced diet to support overall health during recovery.

Comfort Measures: Use over-the-counter fever reducers like acetaminophen (Tylenol) to manage fever and discomfort, as recommended by a doctor.

Isolation After COVID-19 Exposure: Ensure the child is isolated from others if they were recently exposed to COVID-19, even if MIS-C symptoms appear weeks later.

When to Seek Medical Help:

Emergency Signs: Seek immediate medical attention if your child experiences:

Difficulty breathing
Persistent chest pain
Confusion or inability to stay awake
Severe abdominal pain

Consult a Pediatrician: If your child has prolonged fever, rash, or gastrointestinal symptoms, contact a pediatrician promptly for evaluation.

Telehealth Options:

Telehealth services can help parents assess symptoms and determine if immediate in-person care is necessary.

Teladoc Health: Teladoc offers virtual consultations with pediatricians who can evaluate symptoms of MIS-C and guide you on whether emergency care is needed.

Amwell: Amwell’s pediatric specialists can provide advice on fever management, rashes, and gastrointestinal symptoms and recommend the appropriate care pathway.

PlushCare: PlushCare allows parents to consult with pediatricians who can help assess symptoms and advise on the urgency of care.

MDLIVE: MDLIVE connects parents with pediatricians who can guide you through early symptom evaluation and management, helping you decide whether to visit urgent care or an emergency room.

Cost Estimates for MIS-C Evaluation and Treatment:

MIS-C requires comprehensive medical evaluation and often hospitalization. Below is a breakdown of potential costs:

In-Person Visits:

Pediatrician Visit (Non-emergency): For initial assessment of fever, rash, or fatigue.
- Cost: $100 - $250 per visit.
Urgent Care Center: For non-life-threatening symptoms like rash, fever, or abdominal pain.
- Cost: $75 - $150 per visit, with additional costs for tests or IV fluids ($200 - $500).
Emergency Room Visit: For severe symptoms like chest pain, breathing difficulties, or altered mental status.
- Cost: $1,000 - $3,000 for evaluation and testing.

Hospitalization Costs:

ICU Stay (Severe Cases): Children with MIS-C often require monitoring in the intensive care unit for complications like heart inflammation or organ failure.
- Cost: $5,000 - $10,000 per day, with an average stay lasting 5-10 days.
Intravenous Immunoglobulin (IVIG) Treatment: IVIG is often used to reduce inflammation and treat MIS-C.
- Cost: $3,000 - $10,000 per dose.
Steroids or Other Medications: Anti-inflammatory medications like corticosteroids may be prescribed.
- Cost: $50 - $500 depending on the drug and duration of treatment.

Lab and Imaging Costs:

Blood Tests: To assess inflammation levels, organ function, and markers of MIS-C.
- Cost: $200 - $500.
Echocardiogram (Heart Ultrasound): To evaluate heart inflammation or function.
- Cost: $500 - $1,500.
Chest X-ray or CT Scan: To check for lung involvement or other organ issues.
- Cost: $200 - $1,000.

Recommended Care Pathway:

Telehealth Consultation: If your child develops persistent fever or a rash, start with a telehealth consultation to determine the need for in-person evaluation.
Pediatrician or Urgent Care Visit: For mild to moderate symptoms like rash, gastrointestinal issues, or fatigue, visit a pediatrician or urgent care facility for initial evaluation.
Emergency Care: If severe symptoms such as chest pain, difficulty breathing, or confusion are present, seek immediate emergency care.
Hospitalization for Severe Cases: MIS-C often requires hospitalization to manage inflammation, provide IV fluids, and monitor organ function.

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Meet Emma:

Emma, a 6-year-old girl, developed a persistent fever and rash two weeks after recovering from a mild case of COVID-19. Concerned about the symptoms, her parents scheduled a telehealth visit with Teladoc Health. The pediatrician recommended an in-person visit with their primary care doctor.

After an in-person evaluation, Emma’s pediatrician noted signs of MIS-C and referred her to the emergency room for further testing. Blood tests and an echocardiogram confirmed inflammation in her heart and elevated markers of MIS-C. Emma was admitted to the hospital and treated with IV fluids, IVIG, and corticosteroids.

Emma stayed in the hospital for five days, incurring the following costs:

Telehealth visit: $75
Pediatrician visit: $150
Emergency room visit and tests: $2,500
Hospitalization and treatments: $20,000

Emma’s total treatment cost was $22,725, but her parents were relieved that prompt care led to a full recovery.