Norton Children’s Pediatric MIS-C Multidisciplinary Clinic is the first clinic in the region set up to follow children after MIS-C hospitalization following suspected or confirmed COVID-19 diagnosis.

Story by: Kim Huston on June 5, 2020

Norton Children’s has created a multidisciplinary clinic for children who have experienced multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. Norton Children’s Pediatric MIS-C Multidisciplinary Clinic will give children who were hospitalized with MIS-C follow-up care with a team of pediatric specialists who can monitor the child for any short- and long-term effects of MIS-C. Norton Children’s is the first pediatric health system in the region to develop a clinic dedicated specifically for MIS-C care.

What is MIS-C?

In early April, physicians in the United Kingdom recognized increased reports of previously healthy children presenting with a severe inflammatory syndrome with Kawasaki disease-like features. In late April, New York City health care providers began seeing children and young adults with similar symptoms. In early May, the condition found its name: multisystem Inflammatory syndrome in children (MIS-C). Norton Children’s Hospital also began seeing cases of MIS-C at that time. The case definition for MIS-C includes:

• An individual under age 21 presenting with fever, laboratory evidence of inflammation affecting multiple systems of the body (brain, heart, kidneys, lungs, blood, gastrointestinal system, skin) that causes severe illness requiring hospitalization
• No alternative diagnoses or reasons for the inflammation
• Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the four weeks prior to the onset of symptoms

Why create a multidisciplinary clinic for MIS-C?

The medical community, including the Centers for Disease Control and Prevention, is still learning about MIS-C and how it affects children. Since the syndrome is still a new phenomenon, not a lot is known about the short-, mid- and long-term effects of the condition. Norton Children’s created the clinic to take a proactive step to monitor children for any late effects (a condition that appears after the acute phase of a condition has run its course) of MIS-C, such as heart conditions like arrhythmias.

Who can be seen in the MIS-C clinic?

The multidisciplinary clinic is for children who have been hospitalized with MIS-C symptoms. Children will be followed closely in the clinic after discharge. Each child’s situation and treatment plan will be unique.

“We need to keep our eyes on MIS-C patients to make sure that they don’t develop heart conditions or other issues over time,” said Brian J. Holland, M.D., chief of pediatric cardiology with Norton Children’s Heart Institute, affiliated with the UofL School of Medicine.

At the clinic, children will receive care from providers in various pediatric specialties, including:

• Cardiology
• Infectious diseases
• Rheumatology
• Surgery

Depending on a child’s specific needs, they may see other pediatric subspecialists as part of their MIS-C multidisciplinary clinic visit, such as neurology, nephrology and/or gastroenterology. A nurse navigator with the clinic can help coordinate visits and care for a child and the child’s family.