Singapore boy, 4, in ICU with rare case of COVID-linked inflammatory syndrome

SINGAPORE – There have been four cases of Multi-system Inflammatory Syndrome in Children (MIS-C) involving children to date, with a four-year-old boy warded in the Children's Intensive Care Unit (CICU) as of Saturday (6 November).

In a media statement, the Ministry of Health (MOH) said that the boy's breathing is being supported by mechanical ventilation. He was admitted to KK Women’s and Children’s Hospital’s (KKH) CICU on 1 November. "He had previously tested positive for COVID-19 infection on 24 September. The KKH paediatric teams are actively managing his care," the ministry said.

MOH added that such cases are considered rare and that the four cases of paediatric MIS-C are among the over 8,000 paediatric COVID-19 cases seen in Singapore since the start of the pandemic.

MIS-C is similar in presentation to Kawasaki Disease. The latter has been linked to various viral or bacterial infections, and occurs in 150 to 200 children a year in Singapore. Symptoms of MIS-C include persistent fever above 38.5 deg C for three days or more, with difficulty breathing; headache; neck swelling; rash; swollen hands and feet; conjunctivitis; diarrhoea; and abdominal pain.

Additionally, there is a two-month-old female infant who was admitted to KKH General Ward on 3 November. She was previously admitted to KKH for COVID-19 infection on 12 October, and discharged on 19 October. The infant's condition is stable, with no oxygen requirements, the ministry said.

The other cases are:

• A three-year-old boy admitted to the National University Hospital (NUH) CICU on 16 October. He had repeatedly tested PCR-negative, but his serology test results indicated that he likely had a COVID-19 infection two to six weeks prior to the development of MIS-C. He has since recovered and was discharged on 23 October.

• An eight-year-old boy admitted to KKH CICU on 27 October. He had been previously diagnosed with COVID-19 infection on 30 September. He has since recovered and was discharged on 1 November.

In May 2020, the MOH said, an international review from 26 countries reported a MIS-C incidence of 0.14 per cent – 14 in 10,000 – among all children with COVID-19 infection.

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