What led to the death of 7-year-old Shreyash?

Shreyash with his father Raju Vhorkate

"Mera bachcha chala gaya, lekin kisi aur ka bachcha nahi jaye, bas yahi dua karta hoon," (I lost my son, do not want any other parent to lose their child, is my prayer) said Raju Vhorkate, 33, a resident of Sector 2, Kalamboli, in Panvel Municipal Corporation. His seven-year-old son, Shreyash passed away on July 7 after being diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C), which is a post-Covid complication usually seen in children. But Shreyash was never treated for Covid-19 and never showed any symptoms of it, claimed Vhorkate.

The sudden demise of Shreyash, a Std II student, has left not only his parents but even his doctors baffled, as his condition deteriorated within a span of a few hours.

Shreyash's parents and younger sister Shreya, 4, are inconsolable. The parents are clueless as to what happened to Shreyash who had never ever visited a doctor for a serious reason until last weekend.

Started with fever

According to Raju, who runs a transport business, Shreyash had a fever on July 2, but after his mother gave him some medicine, he was normal and played the entire day. On Saturday at 5.30 am, he again developed a high-grade temperature.

"We gave him some medicine again and he was fine. When he began to vomit, I took him to a local paediatrician, as we suspected it to be a case of food poisoning. Shreyash had some junk food the previous day. The doctor examined and subsequently got him admitted for observation," said Raju.

Raju added, "Other than the 104 plus temperature, he was conscious. However, by Saturday evening, Shreyash developed convulsions and became serious and slipped into an unconscious state. We shifted him to a private children's hospital in New Panvel. He was shifted to the ICU and later put on life support."

"The paediatricians at the hospital conducted numerous tests, even to check if he had Covid-19. They said he could have been asymptomatic. He was then diagnosed with Paediatric Multisystem Inflammatory Syndrome in Children (MIS-C)," said Raju.

The doctors requested the family to arrange for a Tocilizumab injection, which is now restricted and not available across counters. They also asked Nidhi Choudhary, collector Raigad and Guardian Minister Aditi Tatkare for help. Soon after the injection was administered, Shreyash showed some improvement by passing urine and stool, but never came out of the brain damage due to lack of blood pressure during the convulsions. He finally breathed his last on July 7.

"The doctors informed us that MIS-C causes fever in children, which lasts for a few days, but death due to MIS-C is not common. Many children in the various age groups are being treated at home for similar symptoms - fever, vomiting, diarrhoea. etc. but they get back to normal eventually. Only my Shreyash could not fight it. Both he and his sister Shreya spent time at home and none of us in the family, including their grandparents had any Covid-19 symptoms ever. If Shreyash, as doctors claim, had Covid a few months ago, he would have shown some symptoms," said an emotional Raju.

Also read: Covid-19 cases in Mumbai remain stable

‘An aggressive case'

Dr Pankaj Titar from the NMMC Covid Care Centre from Kharghar said, "MIS-C and multi-inflammatory syndrome in neonates is a dreaded complication that can happen to children 3-4 weeks after Covid exposure. If cases rise, then in the third wave, medical apparatus will have to deal with two front challenges - it will have to engage with Covid-19 cases and on the other it will have to put up a front against MIS-C. The cases found in Panvel region should be documented by the municipal corporation, but I am yet to see a case as aggressive as Shreyash's in Navi Mumbai and Panvel."

"Children mostly are asymptomatic in Covid-19, but in MIS-C they may have fever, abdominal pain, diarrhoea and in severe crisis they may also suffer from heart failure and encephalopathy. Early diagnosis is the key. The government should invest in NICU and PICUs simultaneously as 2 per cent children suffering from MIS-C may require ventilators. The national technical advisory group on immunisation should also hurry up with the study to immunise children," the doctor said.

Dr Mahesh Mohite, who runs Sai Child Care Hospital, New Panvel, where Shreyash was treated, said, "Shreyash was brought in a critical condition, the pumping power of the heart had drastically come down to 10 per cent and we had to immediately put him on ventilator support and started all the emergency lines of treatment in the ICU to revive him. We had even started steroid treatment."

Dr Mohite said, "On average every week I examine one or two cases of MIS-C and since last August till date I have seen almost 55 to 60 cases [35 to 40 cases during first wave and 20 cases during second wave till date]. But most children respond well to the treatment and symptoms subside with prompt timely treatment. Unfortunately, Shreyash is the only child who could not be saved."