Dr. Newburger, who was not involved in the British report, called it a “small but important study” that “contributes new information to the knowledge gap about long-term effects of MIS-C.”
She and the authors themselves noted that there were limitations to the findings because the children in the study were not compared with a control group of children without MIS-C or those with other illnesses. It is unclear, for example, if their emotional problems and muscle weakness were the result of the syndrome, the process of being hospitalized for an illness or other stressors during this time. “Mental health and physical conditioning have taken a hit in children and adolescents in general during the pandemic,” Dr. Newburger said.
Dr. Srinivas Murthy, an associate professor of pediatrics at the University of British Columbia, who was not involved in the new study, said it might be difficult to tease out which residual problems were directly attributable to the syndrome and which might have resulted from any critical illness. He said the fact that some of the children still had trouble with muscle weakness and endurance could yield important lessons, because such issues can require a different kind of a care including “post-hospitalization rehabilitation opportunities.”
In fact, Dr. Penner said, the team at Great Ormond Street Hospital has made changes in the treatment of children hospitalized with the syndrome since the fall, because it has recognized “how affected their muscles are at the onset and how profoundly fatigued and weakened these kids are.”
In the hospital, for example, “often just transferring from the bed to the toilet is exceptionally difficult for these children,” he said.
The hospital now has a more concerted focus on providing the children in-hospital physical therapy and work with musculoskeletal therapists, he said, and it sends them home with an individualized rehabilitation plan that is linked to an app.
“We’ve also involved our occupational therapists, and we’ve developed a fatigue program that’s run once a month where the parents dial in for a group session,” Dr. Penner said. “I think the main message that we give them is to avoid this boom-and-bust cycle, where the kids try to do the things they used to do at full speed and then they kind of crash afterwards — as opposed to a gradual increase of activity back to their normal state.”