Precision Decisions in MIS-C: Towards improving outcomes in children with COVID-19
COVID‑19 can cause a life-threatening Multisystem Inflammatory Syndrome in Children (MIS-C) typically weeks after a mild or even asymptomatic infection. Each wave of COVID‑19 cases is closely followed by a wave of previously healthy children presenting to hospital in shock and heart failure due to uncontrolled inflammation. The new syndrome closely resembles Kawasaki Disease (KD). KD is the result of an infection, which triggers an over active immune system resulting in fever and inflammation of blood vessels, most importantly the coronary arteries. Similar to KD, one in four children with MIS-C develops coronary artery inflammation. It is critical to enable health care teams to rapidly recognize MIS-C, identify high risk children and control the life-threatening inflammation before it damages the child’s heart. Our team has studied and dissected the reasons responsible for inflammation leading to shock and hyperinflammation in KD and have identified key biomarkers and targets for treatment. These have been rapidly translated to the bedside resulting in new medications and improved outcomes. These lessons are immediately transferrable to MIS-C, providing the evidence to guide development of effective therapeutic approaches. Our team includes doctors, scientists, and families working together to tackle this serious disease. We will use machine learning and artificial intelligence to analyze biologic and clinical data to rapidly diagnose MIS-C and predict which child will develop severe disease. We’ve successfully done this before in other diseases. We already have a strong and deeply committed Canada-wide team, expertise and infrastructure in place from our other successful projects and national networks. We have partners in Europe and the USA, where we have established the same processes so that we can be most efficient and not have to reinvent the wheel. We will seamlessly share information to rapidly improve care for affected children around the world.