Mumbai: MIS-C now found in newborns two weeks after delivery, say doctors

Doctors are witnessing multisystem inflammatory syndrome in children (MIS-C) now in newborns as well, two weeks after delivery. It is normally detected in children who have recovered from COVID-19. Hospitals like the Wadia Hospital and JJ Hospital have reported cases where new born babies have been diagnosed with the syndrome merely a week (7 to 8 days) after delivery. Paediatricians have attributed two reasons to it: either newborns have contracted the syndrome through horizontal transmission (post-delivery) or vertical transmission (pre-delivery). Meanwhile, members of the paediatric task force believe the newborns have in-built antibodies for COVID-19. Two weeks later, they are diagnosed with MIS-C.

According to the doctors, children after 4 to 6 weeks of recovering from COVID-19 develop this condition, where different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

A senior paediatrician from civic-run hospitals said they have seen two cases of neonatal-onset MIS-C. The newborns were three to four weeks old. Their symptoms included rashes, redness of eyes, respiratory distress and fever. We also encountered cardiac dysfunction in the children. Although the babies were all admitted for 10 to 12 days, they recovered successfully from the condition. “While we do not know what causes MIS-C yet, there are multiple case reports from across the world and from India as well on neonatal multisystem inflammatory syndrome due to COVID-19. However, the associated mortality rate is very low,” he said.

Dr Bakul Parekh, past president of the Indian Academy of Paediatrics (IAP) and part of the paediatric COVID-19 task force, refuted the claims. He believes that the presence of such antibodies in newborn babies has no role in their health. Moreover, they have come across newborns being diagnosed with MIS-C two weeks after their delivery, which means they had virus-related illnesses and later they developed MIS-C. “Newborns with inbuilt antibodies and developing complications after birth happen in the rarest of rare cases. Also, it can’t be attributed to the antibodies present in their bodies. Antibodies help to fight against the pathogens, so it is assumed that it helps in building the immunity,” he said.

Dr Bela Verma, head of the paediatric department of the hospital and former president of Mumbai Association of Paediatrics, said, “Though there hasn’t been any official confirmation on vertical transmission, development of MIS-C indicates the possibility of infection in the uterus. We have two to three such cases where babies have developed MIS-C within a week of delivery.”

Box:

A study —Single-cell RNA-seq identifies cell subsets in human placenta that highly expresses factors driving pathogenesis of SARS-COV-2— published jointly conducted by the Indian Council of Medical Research (ICMR), National Institute of Research in Reproductive Health (NIRRH) at Parel and Indian Institute of Science (IISc) in Bengaluru, revealed that the Sars-CoV-2 virus, which causes COVID-19, can infect the placenta in pregnant women. However, it was not established if a pregnant woman can pass on the infection to her child.

Several doctors pointed out that newborns can get COVID-19 antibodies in various ways. If the mother has suffered from the virus and if there is a transplacental transfer, the baby may develop antibodies. The second way is if the mother had the virus earlier and she has antibodies in her blood. Those antibodies can get transferred to the baby.

“More research about the source of antibodies in neonates with MIS-C needs to be evaluated as well as the assumption that maternal antibodies are protective against COVID-19 infection,” said the doctor.

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