Hi everyone and welcome to E.M. Basic. My name is Zach Hodges and I'm a pediatric

hospitalist at the Medical College of Georgia. I'm excited to bring you another crossover

episode with our MCG pediatric podcast. Today we will be discussing MISC and to do that, I'm

joined by pediatric cardiologist Dr. Pushpa Shivaram, pediatric rheumatologist Dr. Jalya Patel and future pediatric resident Sonal Dugar.

If you enjoy this episode, check out our MCG pediatric podcasts for more great content.

With that, let's jump right into the discussion.

Dr. Chiviram, what exactly is MISC and how did we first learn about this syndrome?

MISC, or MISC, is thought post-infectious multisystem hyper-inflammatory syndrome

that has been described in children who have been previously infected with SARS-CoV-2 or COVID-19.

Interestingly, when we are reading about pediatric COVID-19 cases in China in early 2020,

there was no mention of this hyper-inflammatory syndrome in

children. We even thought the children were mostly spared from severe SARS-CoVito infection.

In late April 2020, an alert came from the United Kingdom that reported a rising number of cases

of multisystem hyper-inflammatory syndrome. It also seemed to overlap with toxic shock syndrome and

atypical Kawasaki disease. These children were suffering from what was thought to be a new

syndrome temporarily associated with COVID-19 with the development of symptoms about three to four

weeks after a large number of local SARS-CoV2 infections. This syndrome was characterized by persistent

fever and a combination of symptoms

including hypotension, multi-organ system dysfunction and elevated inflammatory markers.

Only about one week later on May 4th, three children were reported to have died in New York

of likely Miss C. This led the CDC on May 14th to release an official health advisory asking pediatricians

across the United States to report any cases that may fit their clinical syndrome. And by May 28,

...