Mother of boy in ICU with rare inflammatory syndrome after COVID-19 warns parents of symptoms to look out for
SINGAPORE: Although four-year-old Muhammad Ali Zafir Mohamed Azmi was his usual active self when he went to his childcare centre on the morning of Oct 29, he complained of tiredness when he returned home that afternoon.
Running a fever of 38.8 degrees Celsius, Ali's temperature subsided after taking ibuprofen, a fever medication. But his temperature rose again, consistently staying above 38 degrees Celsius, said his mother Marilyn Cacanindin.
Other symptoms, including involuntary jerking in his sleep, bruised hands and feet, and stomach pain soon appeared.
“He asked me, ummi (mummy) can you urut (massage) my stomach? My stomach is in pain,” said Ms Cacanindin, adding that he also suffered from chills.
Five members of the family - Mr Mohamed Azmi Lendang and his wife Ms Cacanindin, together with Ali and his two elder siblings - had contracted COVID-19 in September and recovered. The youngest daughter, aged one, and their domestic helper did not contract the disease.
She did not suspect that Ali had contracted the coronavirus again as antigen rapid tests came back negative.
Ali did not get better, even after a visit to a general practitioner’s clinic, and Ms Cacanindin asked her husband to send their son to the hospital.
Upon admission to KK Women's and Children's Hospital (KKH), Ali was transferred from the high dependency ward to the intensive care unit (ICU), where he was intubated.
Doctors diagnosed him with multi-system inflammatory syndrome in children (MIS-C), a rare condition that affects some children in the weeks following a COVID-19 infection.
The Ministry of Health (MOH) said on Saturday (Nov 6) that it has detected four cases of MIS-C among more than 8,000 paediatric COVID-19 cases in Singapore since the pandemic began last year.
All the cases were admitted to hospitals in October or November. Besides Ali, the other cases of MIS-C comprise two boys, aged three and eight, and a two-month-old baby girl.
Of the four, only Ali remains in hospital.
On Monday, Senior Minister of State for Health Dr Janil Puthucheary said during a press conference that a fifth case of MIS-C has been detected, though he did not provide further details.
MOH said the symptoms of MIS-C include persistent fever above 38.5 degrees Celsius for three or more days. Other symptoms include difficulty breathing, headaches, neck swelling, rash, swollen hands and feet, conjunctivitis, diarrhoea, or abdominal pain, the ministry added.
An international review in May last year reported an MIS-C incidence rate of 0.14 per cent - or 14 in every 10,000 cases - among all children with COVID-19.
"MIS-C is similar in presentation to Kawasaki disease which has been linked to various virus or bacterial infections, and occurs in 150 to 200 children a year in Singapore,” MOH said.
In addition to being intubated, Ali was given various medication, and placed on a ventilator for a week. He has since been taken off the ventilator and is undergoing physiotherapy while still in ICU.
His condition is now “stable but fragile”, his parents said, adding that doctors have not informed them of when they expect Ali to recover.
Ms Cacanindin praised the hospital staff for their efforts in treating Ali, gently talking him through procedures and making sure he was comfortable.
“He was treated nicely by the doctors and the nurses, they are very professional when dealing with Ali,” she said.
Ms Cacanindin and Mr Azmi said they hope that by sharing Ali’s story, other parents will be aware of what to look out for, should their child be affected by MIS-C.
Ms Cacanindin also shared an account of Ali’s experience on her Facebook page, which has been shared more than 300 times as of Tuesday evening.
She said that Ali’s elder siblings miss him, and are constantly asking if they can talk to him or see pictures or videos of him.
“They're very concerned because they are very close,” she said. “We just want him to recover. So many people are praying for him.”