In April of 2020 , healthcare |
But there are established |
“ We needed to adapt ,” |
Dr . Jone . “ That ’ s not |
systems around the world |
courses of treatment . As in |
says Dr . Jone . |
good . Some will get a kidney |
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faced a steep and urgent learning curve : COVID-19 was spreading rapidly , and much about it remained unknown .
Some of the most pressing questions in pediatrics revolved around MIS-C , a severe complication that , while rare , came with some familiar hallmarks — at least to those who knew what to look for .
“ Rash , red eyes , red lips , diarrhea , common things we see in Kawasaki disease ,” says Dr . Jone . “ Both are a hyperimmune response to trying to fight infection .”
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Kawasaki disease , patients with MIS-C responded to intravenous immunoglobin , or IVIG , a blood product containing thousands of antibodies . Drs . Jone and Dominguez , who ’ d run a Children ’ s Colorado Kawasaki Clinic together since 2011 , started doing MIS-C rounds in spring of 2020 , bringing together the infectious disease and cardiology teams to talk through each case every day at 9 a . m .
In many cases , they found , IVIG wasn ’ t enough .
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CATCHING IT EARLY
By fall of 2020 , it was clear that , when it came to MIS-C , time was of the essence .
“ Patients with MIS-C have higher levels of systemic inflammation and more often decompensate ,” says Christina Osborne , MD , “ which puts them at risk for requiring admission to intensive care .”
“ They can get myocarditis and very low blood pressure . The heart function goes down , the coronary arteries dilate ,” adds
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or liver disorder , their blood pressure gets so low . Some go into shock .”
Dr . Osborne , a former fellow in pediatric infectious disease and current fellow in critical care with a research interest in coronaviruses , took on the task of creating a protocol for identifying MIS-C early , with input from infectious disease , hospital medicine , critical care , cardiology , rheumatology and emergency medicine . The protocol combined recommendations from the Centers for Disease Control
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