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Dell Children's one of 30 hospitals studying post-COVID-19 inflammatory syndrome in kids

Nicole Villalpando
Austin American-Statesman
Dell Children's Medical Center of Central Texas is part of the research study on children with multisystem inflammatory syndrome.

Dell Children's Medical Center of Central Texas is joining 29 other children's hospitals in the United States and Canada in a study of kids who have had Multisystem Inflammatory Syndrome in Children after contracting COVID-19.

This is the first time Dell Children's has participated in a Pediatric Heart Network study. Once the paperwork is submitted for this study, Dell Children's will become part of the network. 

"This will open many doors for us to do other pediatric cardiac studies," says Dr. Keren Hasbani, a pediatric cardiologist and director of cardiac magnetic resonance imaging at Dell Children's. She is leading the study at Dell Children's.

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Being part of the network puts Dell Children's on the map for federal funding for cardiac studies and to be able to do innovative treatments and surgeries as part of the network, she says. "It means that our hospital has gotten to a level that it is able to play with the big boys," she says. 

Dr. Keren Hasbani is a pediatric cardiologist and director of cardiac magnetic resonance imaging at Dell Children's Medical Center of Central Texas.

The study is enrolling 600 kids who have had the syndrome and following them for the next five years. Since the virus began, Dell Children's has seen 36 patients with Multisystem Inflammatory Syndrome in Children, also known as MISC.

MISC is characterized by kids who have had some exposure to COVID-19 four to six weeks earlier. Typically they had a mild case of COVID-19 or were asymptomatic.

Then they start to have very high fevers that cannot be controlled by medications. Their eyes become red; they might have a rash; their lips are chapped; the skin on their hands and feet starts to peel; they might have headaches and body aches; and they can be irritable.

In MISC, "the immune system goes crazy," Hasbani says. "It over-responds to the COVID and responds to the body itself." 

These kids no longer test positive for COVID-19, but most of them have the antibodies to the virus.

Cardiologists are interested in MISC because it causes inflammation in the arteries, especially the coronary arteries, and can cause them to dilate, leading to long-term side effects. 

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Hasbani has been working with Boston Children's Hospital, Children's Hospital of Philadelphia and other centers on another study that is not part of the network. Those connections led Dell Children's to be considered for this study and the network.

Joining the network is another chapter in the growth story of the Texas Center for Pediatric and Congenital Heart Disease at Dell Children’s and UT Health Austin, the clinical practice of Dell Medical School at the University of Texas.

Since the center began in 2018, it has become a heart transplant center, having now performed two transplants. It is now is able to offer a full range of mechanical assist devices including the left ventricular assist device and Berlin Heart mechanical heart pump. 

Much of the "firsts" at the center have been on the surgical side. This study and becoming part of the Pediatric Heart Network is a "first" for the clinical side. 

The MISC study will look at the long-term effects these kids experience. A  second arm of the study will look at the genetics to try to answer why some kids have this immune response after having COVID-19 while most to do not. 

Hasbani says kids with MISC tend to be older. At Dell Children's, the average age is 12. Across the country, it's 14. The kids with MISC also were healthy kids before they became sick. 

They do become better quickly, she says, once they are given interventions such as immunoglobulin therapy and steroids to calm down the immune system and blood thinner to stop the body from making too much clotting factor. Sometimes the kids also need extra oxygen or some adrenaline to increase heart function. 

They usually spend a day or two in the intensive care unit before being moved to a regular room. They are hospitalized for three to seven days.                      

Hasbani is able to reassure parents that these kids do well with treatment. The information coming from hospitals in New York and Boston, where kids were first seen with MISC, also is reassuring because those children are doing well eight months later.  

Once a child has MISC at Dell Children's, they will be followed closely even if they do not choose to enroll in the study. Most of the study is collecting data that Hasbani and her team already would collect as part of the follow up plan to look for long-term side effects.

MISC is still very rare, Hasbani says, and parents are right to be more concerned about COVID-19 in older adults and people who are immune compromised, but if a child has unrelenting fever for days, they should call their pediatrician or come to the emergency room. 

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