These days, 15-month-old Madelyn Grant is a boundless burst of energy who doesn’t miss a beat while tagging along with her 4-year-old sister Emma.
“They’re very much into Paw Patrol right now and love playing with their dollhouse,” says their mom, Lauren Grant, a registered nurse in the progressive care unit at Cleveland Clinic Hillcrest Hospital.
But earlier this year, those carefree scenarios were far from certain.
On Jan. 19, Lauren, her husband, Dillon, Emma and Madelyn tested positive for COVID-19.
Their range of symptoms — which included nausea, congestion, muscle aches and fatigue — were mild. Two weeks later, it seemed as though everyone was on the mend and Emma and Madelyn were cleared to return to the daycare center they attended.
The tide took a sharp turn on Feb. 2, though, when Lauren received a text message from a daycare staff member accompanied by a photo of Madelyn’s bare feet and hands. They were dark purple.
“Everything was OK when my husband dropped her off that morning, but now, in addition to the discoloration in her hands and feet, she’d become very fatigued and was struggling to breathe,” says Lauren.
Lauren raced to Cleveland Clinic Twinsburg Family Health and Surgery Center, where antibiotics were administered and a battery of tests were performed.
The results were terrifying: Instead of falling in the normal range of 100 to 120 beats per minute, 5-month-old Madelyn’s heart rate registered between 180 and 210 beats per minute and was continuing to climb. Her white blood cell count was 26,000 — triple the normal count for a child her age.
Two hours later, Madelyn was whisked by ambulance to Cleveland Clinic’s main campus and transferred to the pediatric intensive care unit.
“She was grunting to breathe and not opening her eyes,” Lauren recalls. “We didn’t think she was going to make it. It was a nightmare.”
Dr. Heather Daniels, a pediatric infectious disease specialist and physician, examined Madelyn and made the diagnosis she’d become intimately familiar with: Madelyn was suffering from multisystem inflammatory syndrome in children (MIS-C), a rare but serious condition associated with COVID-19 in which different body parts including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs can become inflamed.
Daniels estimates she’s treated about two dozen MIS-C patients since April 2020.
“The thing we worry about the most with MIS-C is that the blood vessels supplying blood to the heart will become inflamed and enlarged, which can lead to a coronary aneurism or a heart attack,” Daniels explains. “In Madelyn’s case, her immune system was stuck in overdrive, which caused a lot of inflammation.”
According to the CDC — which has been tracking MIS-C in the United States since May 2020 — 5,217 children have met the case definition of the illness and 46 have died as of Oct. 12, 2021.
“For the most part, the kids we’ve seen are doing fairly well once they’ve recovered,” Daniels says. “But it really remains to be seen if there will be any long-term outcomes.”
To combat the illness, Daniels prescribed a regimen of intravenous immunoglobulin antibodies and steroids.
Madelyn continues to experience episodes in which her hands and feet turn purple, then return to normal five or 10 minutes later. But Lauren and Dillon are vigilant about monitoring their daughter’s heart rate and making scheduled visits to her rheumatologist and cardiologist.
“Without question, Dr. Daniels and her team saved Madelyn’s life,” Lauren says.
Kids and Covid
Dr. John Bower, pediatric infectious disease specialist at Akron Children’s Hospital, shares quick facts
on COVID-19 and kids.
1. Children are more likely to be asymptomatic or have mild symptoms often presenting as a common cold with headache, sore throat, vomiting, diarrhea or muscle aches.
2. The risk of transmission to adults with higher risks can be a concern to families.
3. The Pfizer vaccine is approved for children12 to 15 and has full FDA approval for ages 16 and up.