4-year-old in ICU among 4 cases of children found to have inflammatory syndrome linked to Covid-19: MOH

SINGAPORE — Four children in Singapore have developed a syndrome linked to a previous Covid-19 infection, which is known to cause symptoms such as persistent fever and difficulty in breathing, said the Ministry of Health (MOH) late on Saturday (Nov 6).

The condition, known as paediatric multisystem inflammatory syndrome in children (MIS-C), is considered rare and the four cases have been detected among the more than 8,000 children infected with the coronavirus here since the start of the pandemic, the ministry said in a statement.

One of the four cases is a four-year-old boy who is now in a children’s intensive care unit (CICU) with his breathing supported by mechanical ventilation. 

Of the three others, one — a two-month old girl — is in a general ward while two others have been discharged.

“MIS-C is similar in presentation to Kawasaki Disease which has been linked to various virus or bacterial infections, and occurs in 150 to 200 children a year in Singapore,” MOH said. 

Symptoms of MIS-C include a persistent fever above 38.5°C for three days or more, with difficulty in breathing, headache, neck swelling, rash, swollen hands and feet, conjunctivitis, diarrhoea, or abdominal pain.

Kawasaki Disease, meanwhile, is an illness that results in inflammation in blood vessels throughout the body and primarily affects children younger than five years old.

The four cases are: 

• A four-year-old boy admitted to KK Women's and Children's Hospital’s (KKH) CICU on Nov 1. The boy remains in the CICU and his breathing is supported by mechanical ventilation. He had previously tested positive for Covid-19 on Sept 24. MOH said that the hospital’s paediatric teams are actively managing his care

• A two-month-old girl admitted to KKH general ward on Nov 3. She was previously admitted to KKH for Covid-19 on Oct 12, and discharged on Oct 19. MOH said the patient’s condition remains stable, with no requirement for oxygen support

• A three-year-old boy admitted to the National University Hospital’s CICU on Oct 16. He had repeatedly tested negative in polymerase chain reaction swab tests, but his serology test results indicated that he likely had a Covid-19 infection two to six weeks prior to developing MIS-C. He has since recovered and was discharged on Oct 23

• An eight-year-old boy admitted to KKH CICU on Oct 27. He had been previously diagnosed with Covid-19 on Sept 30. He has since recovered and was discharged on Nov 1

MOH said that an international review from 26 countries in May last year reported a MIS-C incidence rate of 0.14% (14 in 10,000) among all children with Covid-19 infection.

The ministry added: “As MIS-C is linked to previous Covid-19 infection, measures such as mask wearing, hand hygiene and safe distancing measures remain important to reduce the risk of contracting Covid-19 infection.”