Coronavirus Chronicles: Combatting the Superantigens?

Q: For a child, what could be worse than having COVID-19?
A: Having it and apparently recovering; and then, within weeks, learning that this chapter of the story is not over.

Imagine being the parent of a daughter or son who tests positive, and is sick for a while, and gets better. Then one day there is a fever, or a rash, or blisters, or vomiting, or diarrhea, or eyelids that are puffy and/or red; or blue fingers, swollen hands, blue lips, or what doctors used to call “total body pain,” or the inability to walk.

With Multisystem Inflammatory Syndrome in Children (or MIS-C for short) the number of potential responses is not yet known. So many possibilities exist because its basic nature is to affect any body part of its choosing. One explanation, writes Liz Szabo, is that some viruses produce toxins that contain “superantigens,” which…

[…] bypass the body’s normal safeguards and attach directly to T cells. That allows superantigens to activate 20% to 30% of T cells at once, generating a dangerous swarm of white blood cells and inflammatory proteins called cytokines…

And this is what causes the extreme and seemingly random inflammation. Of course, after the first symptoms, it can get worse, progressing to more than one type of heart dysfunction and other undesirable outcomes, including aneurysms and bleeding from the nose, mouth, and eyes. One by one the organs give up, and then comes brain death.

New and frightening outcomes

Earlier this year, the median age for getting the syndrome was nine years. The condition is only MIS-C in the pediatric demographic (infancy to age 20). After that, it is MIS-A for adults, and yes, that happens. Imagine being a child with a parent suffering through MIS-A, unable to do the parent things.

Lately, the kids get sicker than we have been accustomed to seeing, including many who manifested few symptoms from the original case of COVID-19. For The New York Times, Pam Belluck described a 15-year-old boy who stuck pretty close to home and caught the virus, and then MIS-C, anyway. She mentioned an 11-year-old star soccer player who lost at least a year of sport, and a 15-year-old who “needed a procedure that functioned as a temporary pacemaker.”

Another young teen, described as overweight but active, suffered severe multisystem organ failure, meaning lungs, heart, and kidneys. The sickness puts kids on all kinds of meds:

Doctors said they’ve learned effective treatments, which, besides steroids, immunoglobulin and blood thinners, can include blood pressure medications, an immunomodulator called anakinra and supplemental oxygen.

More than 5,200 of the 6.2 million U.S. children diagnosed with COVID have developed MIS-C. About 80% of MIS-C patients are treated in intensive care units, 20% require mechanical ventilation, and 46 have died.

It seems odd to be told that scientists “don’t know exactly what causes it” or that “most children who develop MISC-C were previously healthy.” They previously had COVID-19, which is not a condition of health. The causal relationship seems obvious, even if the mechanism is not.

Your responses and feedback are welcome!

Source: “COVID-Linked Syndrome in Children Is Growing and Cases Are More Severe,”, 02/17/21
Source: “Scientists Search for Cause of Mysterious COVID-Related Inflammation in Children,” 10/20/21
Image by Jernej Furman/CC BY 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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