Scientists study first Nigerian child to develop this severe Covid-19 complication

In 2020, researchers looked into the case of the first child in Nigeria with severe Covid-19 disease to develop multisystem inflammatory syndrome (MIS-C). This is a rare but serious complication of Covid-19 that affects many different parts of the body. 

Inflammation happens when inflammatory cells travel to a place of injury or infection in the body and helps to fight off infections or heal the body. 

Cases from Europe and North America had shown that many children with African origins developed MIS-C, but this was not seen in Africa at the time. When a Nigerian patient with Covid-19 had been diagnosed with MIS-C, researchers were keen to investigate.

The researchers looked at the records of the 12-year-old Nigerian patient who was diagnosed with MIS-C and Covid-19 to help them understand more about this disease and how to recognise the symptoms. 

They found that the patient was diagnosed with MIS-C because she had a fever lasting more than 3 days, had rashes or swelling of hands and feet, experienced diarrhoea or vomiting, had a positive Covid-19 test, and showed high levels of specific inflammation markers in her body. Markers are proteins in the blood that marks (shows or indicates) if a person has an infection or disease.

They also noted that she got better when healthcare workers gave her anti-inflammatory medicine.    

By looking into this first case of MIS-C in Africa, the researchers suspected that there were more cases but that they were not being diagnosed correctly. They suggested that doctors should have monitored African children with severe Covid-19 closely for the symptoms of MIS-C.

The authors of this paper were from Nigeria. 

Abstract

Majority of reports of Multisystem Inflammatory Syndrome (MIS-C) associated with COVID-19 have come from Europe and North America, with a paucity of cases in the Asia-Pacific region and Africa. The paucity of reports in Africa is in contrast with the demographics of the series in New York, Paris and UK which reported that children of African ancestry accounted for 40%, 57% and 75%, respectively of all cases of MIS-C. With the global trend of higher prevalence of MIS-C in children of African ancestry, enhanced surveillance and awareness for this syndrome in children with COVID-19 in Africa is therefore important as the previous and current observations of Kawasaki Disease (KD) and MIS-C as a rarity in Africa may be due to under-reporting, a poor index of suspicion and missed diagnosis. A case report of a 12-year old Nigerian girl with MIS-C is presented in line with the WHO call for urgent reporting and global surveillance especially in areas were MIS-C is considered a rarity. This case report stimulates a call for vigilance and expanded effort at surveillance to promote early recognition and diagnosis of MIS-C in Africa; using current case definitions which promote the recognition of MIS-C in areas of resource limitation. The favourable outcome and experience from this case will create awareness, expand knowledge, and support clinicians on the African continent in their approach to other potential cases.

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