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Carlton County mother warns of rare but severe illness linked to COVID-19

Jullian Doward, 17, spent nearly four weeks in the hospital after he diagnosed with Multiple Inflammatory Syndrome in Children (MIS-C).

Jullian Doward was diagnosed with Multiple Inflammatory Syndrome in Children (MIS-C)
Jullian Doward, 17, was diagnosed with Multiple Inflammatory Syndrome in Children (MIS-C), a rare but severe condition that can develop in children and adolescents who have been infected with the virus that causes COVID-19. The condition nearly cost Jullian his life.
Contributed / Monique Doward
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KETTLE RIVER — Jullian Doward, an otherwise healthy 17-year-old student at Barnum High School, unknowingly contracted COVID-19 during Thanksgiving break.

His mild cold-like symptoms were treated with over-the-counter medication and Jullian recovered. However, three weeks later he developed stomach pain and diarrhea, high fever and chills. He also had dizziness, a fast heart rate and chest pain, said his mother, Monique Doward.

MIS-C diagnosis

Jullian was evaluated by Dr. Paula Hedin at Essentia Health-Moose Lake on Dec. 16, 2021. Tests were positive for COVID-19 antibody memory, and seven PCR tests were negative, proving he had COVID-19 illness in the past but no longer had an active viral infection.

Jullian was diagnosed with Multiple Inflammatory Syndrome in Children (MIS-C), a rare but severe condition that can develop in children and adolescents who have been infected with the virus that causes COVID-19. It usually appears about three to six weeks following the infection. MIS-C progresses rapidly and can result in extreme inflammation which decreases the function of multiple organs and systems, including the heart, lungs, eyes, skin and gastrointestinal system, according to Dr. Tamara Pozos, medical director of clinical immunology and a pediatric immunology and infectious disease specialist at Children’s Minnesota.

Jullian was admitted to Essentia Health-Moose Lake the following day, but the hospital was unable provide the specialty and intensive cares needed to treat his illness, according to Pozos and Monique.

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He was transferred to Children’s Minnesota in Minneapolis on Dec. 16, where he received intensive care requiring extracorporeal membrane oxygenation (ECMO), and mechanical ventilation. ECMO is when blood is pumped outside of a person's body to a machine that removes carbon dioxide and sends oxygen-filled blood back to the body.

Significant inflammation in Jullian's heart decreased its ability to pump blood normally to his body, Pozos said. In addition to ECMO and ventilation, Jullian received IV treatments, steroids and medication.

“Jullian is certainly one of the sickest children we have cared for with MIS-C,” Pozos said.

Monique serves on the Kettle River City Council and is a master gardener. She has bachelor's and master's degrees in public health and attended two years of medical school, which came into play as she acted as Jullian’s strongest advocate and collaborator with his medical teams.

“I was shocked and was trying to get a clear understanding of the disease that would attack these various organ systems after recovery from (a) mild over-the-counter treated cold," Monique said.

After a series of sedations and medications, Jullian was removed from ECMO and the ventilator. On Jan. 1, he was moved to the general floor of Children’s Minnesota to receive less invasive care.

“The recovery would come slow,” Monique said. “I helped turn position, change bedding, and wash him from head to toe. I took care of his daily needs while talking to him, knowing I was there with him during the biggest fight in his life. I stayed with Jullian; I held his hand. I never gave up or he never gave up. Every day I was present.”

Jullian was discharged from Children's Minnesota on Jan. 11, after spending nearly four weeks in the hospital.

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Symptoms of MIS-C

Monique hopes by sharing her son’s experience that others will become aware of the dangers of MIS-C. She encourages people to wear a well-fitted N95 mask and to social distance.

“Society has many ways of being affected by the mild cases of COVID, to the depth that a fever and rash can be the onset of MIS-C. And if not caught sooner it could be deadly,” she said.

What Pozos called "the central symptom" of MIS-C is fever, which she said is typically a high fever. Combined with abdominal pain, diarrhea or vomiting, fever that happens three to six weeks after a COVID-19 infection should concern parents, Pozos said, especially if their child hasn't received a COVID-19 vaccine.

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Children who have chest pain, seem newly confused or have trouble breathing should be taken to the emergency room right away, Pozos said. Parents should tell their child's provider if the child had a recent COVID-19 infection and about their concerns for MIS-C.

“One of the most concerning symptoms is when the inflammation decreases the contractile function of the heart, as happened to Jullian,” Pozos said.

According to the Center for Disease Control and Prevention (CDC) , there were 7,880 MIS-C patients and 66 deaths in the United States as of March 28. Fifty-seven percent of MIS-C cases occurred in children who are Hispanic/Latino (1,934 patients) or Black, Non-Hispanic (2,303 patients).

“People of color are more likely to be infected with SARS-CoV-2 for a number of reasons, and so it follows that children of color would have an increased incidence of MIS-C. There is a suggestion that there may be inherited risk factors for MIS-C, but this has not been completely clarified,” Pozos said.

The Minnesota Department of Health reported 198 children met the criteria for MIS-C. Children’s Minnesota cared for approximately 150 of these patients, Pozos said.

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“We saw proportionally more children with MIS-C require ICU care earlier in the pandemic when the condition was less well known, presumably because of delayed recognition,” Pozos said. “With the most recent omicron wave, very few children who have come to Children’s Minnesota have had MIS-C severely enough to require ICU care.”

The CDC states vaccination significantly decreases the risk of both COVID-19 infection and of developing MIS-C.

“Many parents have told us that they had never heard of MIS-C, and even some brought it up to their care teams and were dismissed. And sadly, we have even had families with kids in the ICU with MIS-C who didn't believe the MIS-C was related to COVID and were still determined not to vaccinate against COVID-19 because of the misinformation about the disease and the vaccines,” Pozos said.

Life after MIS-C

Since MIS-C was first described in the spring of 2020, its long-term impacts are not completely understood, Pozos said.

Jullian continues to recover from the multisystem impacts of his illness. He needs ongoing close follow-up by a cardiologist to monitor the recovery of his heart function, and he will also see an endocrinology specialist as his adrenal glands recover from the stress of the illness and the needed steroids, Pozos said.

“We expect with time that his heart will continue to grow stronger and his adrenal glands will regain full function, but since this is a new condition and his case was so severe, it is not surprising that he needs more time," she said.

Jullian is currently being home schooled but misses his peers and tries to keep in touch by chatting with friends online, Monique said. Jullian enjoys riding his bike and wants to play baseball in the future.

“With time, the physicians can determine his full recovery status,” Monique said. “Jullian wants to be normal as most teens, but he is still worried—so am I—that by mingling with too many people he may contract any illness, which currently is not a healthy option for a person in recovery.”

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