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The Pedi-COVID Rx Podcast Series: Beyond the Acute Phase: MIS-C, Long COVID, and Lasting Impact

Infectious diseases

Respiratory medicine

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Description

This program is supported by an independent education grant from Pfizer Global Medical Grants. This online education program has been designed solely for U.S. healthcare professionals only. The content is not available for healthcare professionals in any other countries.

In the final episode of the series, join paediatric infectious disease expert Dr Flor M. Muñoz as she examines the serious post-infectious complications that can follow COVID-19 in children. This episode highlights the clinical features and warning signs of multisystem inflammatory syndrome in children (MIS-C), explores the evolving understanding of long COVID across paediatric age groups, and discusses the broader, lasting impact of COVID-19 on children and families. Emphasis is placed on timely recognition, risk assessment, and the importance of coordinated, multidisciplinary follow-up to support long-term paediatric care.

Accreditation: 0.25 AMA PRA Category 1 Credits™

Session Highlights:

Recognising MIS-C: Review the key clinical and laboratory features of MIS-C, including red flags that should prompt early evaluation in children presenting with fever and systemic inflammation following COVID-19 infection.
Understanding Long COVID: Learn how long COVID can present in children of all ages, the range of possible symptoms, and strategies for incorporating post-acute sequelae of COVID-19 into the differential diagnosis.
Cardiac and Systemic Complications: Put the risk of myocarditis and other systemic effects of COVID-19 into clinical context, including comparison with post-vaccination risk and implications for counselling families.
Long-Term, Multidisciplinary Care: Explore best practices for coordinated follow-up, including the role of specialist clinics, family engagement, and ongoing monitoring to address the lasting impact of severe COVID-19 and MIS-C in high-risk paediatric patients.

Who Should Attend:

U.S.-based clinicians caring for children, including:

Pediatricians
Pediatric Infectious Disease Specialists
Family Medicine and Internal Medicine Physicians
Primary and Urgent Care Providers
Advanced Practice Providers (NPs, PAs)

Faculty

Dr Flor M. Muñoz is an Associate Professor of Paediatrics, Infectious Diseases, and Molecular Virology and Microbiology at Baylor College of Medicine and Texas Children’s Hospital. She is a physician-scientist whose work centres on respiratory viral infections, vaccine safety and effectiveness, maternal immunisation, and the prevention of severe disease in high-risk paediatric and immunocompromised populations. Dr Muñoz also contributes to national and international advisory committees and research networks focused on immunisation and infectious disease prevention.

Continuing Education Information

Commercial support: This program is supported by an independent education grant from Pfizer Global Medical Grants.

This continuing education activity will be provided by AffinityCE and MedAll. This activity will provide continuing education credit for physicians. A statement of participation is available to other attendees.

Disclosures

Dr Flor M. Muñoz has disclosed financial relationships within the past 24 months with the following ineligible companies: Pfizer through service on Data and Safety Monitoring Boards for RSV and Group B Streptococcus vaccines, with Sanofi as a member of an adjudication committee, and with Merck through consulting activities as part of a technical advisory group. Her roles as an investigator on paediatric COVID-19 vaccine studies for Pfizer, as well as her consulting relationship with AstraZeneca, ended within the past 24 months.

These disclosures are provided in accordance with ACCME standards to ensure transparency and uphold the integrity of continuing education. Dr Muñoz intends to discuss non-FDA-approved uses of drug products and/or devices and their unlabelled indications during this activity. She will clearly disclose to the audience when such discussions take place.

AffinityCE staff, MedAll staff, as well as planners and reviewers, have no relevant financial relationships with ineligible companies to disclose.

Mitigation of Relevant Financial Relationships

AffinityCE adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CME activity, including faculty, planners, reviewers, or others, are required to disclose all relevant financial relationships with ineligible companies. Relevant financial relationships were mitigated by the peer review of content by non-conflicted reviewers prior to the commencement of the program.

Activity Accreditation for Health Professions

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AffinityCE and MedAll. AffinityCE is accredited by the ACCME to provide continuing medical education for physicians.

AffinityCE designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AffinityCE and MedAll. AffinityCE is accredited by the ACCME to provide continuing medical education for physicians.

AffinityCE designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physician assistants should claim only the credit commensurate with the extent of their participation in the activity.

Nurse Practitioners

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AffinityCE and MedAll. AffinityCE is accredited by the ACCME to provide continuing medical education for physicians.

AffinityCE designates this enduring material a maximum of 0.25 AMA PRA Category 1 Credits™. Nurse practitioners should claim only the credit commensurate with the extent of their participation in the activity.

Nurses & Other Professionals

All other health care professionals completing this continuing education activity will be issued a statement of participation indicating the number of hours of continuing education credit. This may be used for professional education CE credit. Please consult your accrediting organization or licensing board for their acceptance of this CE activity.

System Requirements

Mobile device (e.g., large-format smart phone; laptop or tablet computer) or desktop computer with a video display of at least 1024 × 768 pixels at 24-bit color depth, capable of connecting to the Internet at broadband or faster speeds, with a current version Internet browser and popular document viewing software (e.g., Microsoft Office, PDF viewer, image viewer) installed. Support for streaming or downloadable audio-visual materials (e.g., streaming MP4, MP3 audio) in hardware and software may be required to view, review, or participate in portions of the program

Unapproved and/or off-label use disclosure

AffinityCE/MedAll requires CE faculty to disclose to the participants:

1. When products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not US Food and Drug Administration [FDA] approved); and

2. Any limitations on the information presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.

Participation Costs

There is no cost to participate in this program.

CME Inquiries

For all CME policy-related inquiries, please contact us at ce@affinityced.com.

This continuing education activity is active starting December 16th 2025 and will expire on November 26th 2026. Estimated time to complete this activity: 15 minutes.

Learning objectives

Anticipate and mitigate acute (e.g., fulminant pneumonia, MIS-C) and post-acute (e.g., long COVID, organ dysfunction) complications in high-risk pediatric patients through early recognition, proactive monitoring, and coordinated multidisciplinary follow-up to reduce morbidity and healthcare-system impact.

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Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Welcome to the Quick Consult podcast, brought to you by Metall. Before starting this podcast, please review the faculty information, disclosure statements, and learning objectives using the link in the episode description. To claim your CME credit, complete the evaluation using the link in the episode description. This podcast is a continuing education activity managed and accredited by Affinity CE in collaboration with Metall. This activity is supported by an independent medical education grant from Pfizer Global Medical Grants. Welcome back to the final episode of the PD COVID treatment podcast series, and we are once again honored to be joined by Doctor Fleur Munoz, and today we're going to be talking about what happens beyond the acute phase. We're going to talk about multi-system inflammatory syndrome in children, MISC, long COVID, and, The lasting impact Doctor Munoz, let's start with MISC. What are the key features and warning signs that should prompt a provider to suspect MISC in a child who has recently recovered from COVID-19? Yeah. So, MISC, multisystemic inflammatory syndrome in children, is a complication of COVID-19. It is fortunately a complication that is becoming less and less frequent. And we have, um, in the US a system in place, or several networks in place that have continued to look at the incidence of MISC given that we have ongoing circulation of COVID-19. And Maybe due to the change in variants, due to a change in population immunity, and overall virulence of these, these new strains. Uh, fortunately, with Omicron derivatives or Omicron strains, we, we have not seen as much MISC. Nevertheless, it is a Syndrome that happens still sporadically. And I think that as clinicians, we struggle sometimes in remembering and differentiating this syndrome from other um inflammatory, postinfectious inflammatory processes that we see sometimes. So, for MISC if you recall, um, the important features relate to A post-COVID, uh, number of symptoms that include high fever, that, uh, include, uh, usually, um, the presence of uh cardiac symptoms or respiratory, uh, changes. So that, um, you would have uh some evidence of, of, uh, of cardiovascular, cardiopulmonary disease. But, um, You would also have um immune changes, uh, platelets, white cells. So laboratory findings that would be consistent with an altered uh inflammation response and elevated inflammatory markers, for example, and, and, and other organ involvement. So, I think that um for us to continue to consider MISC in our differential diagnosis, we do need to um think about those, that, those, that high fever and high inflammatory um status that children can be in after a documented COVID-19 infection. And differentiated from Kawasaki disease, which is also very common. MISC could give you a rash as well. It can give you GI symptoms as well. Um, so, I would say the most important, uh, message I would give you is that do not forget to include MISC in your differential diagnosis of, uh, a child who presents with the syndromic, uh, findings of a In increased inflammatory state with fever after having had usually a respiratory infection. Moving to the longer term sequelae, how should clinicians recognize and manage long COVID or post-acute sequelae of COVID-19 in children? Yeah, so long COVID is another important Uh, point of discussion. And at some moment, you know, even though we might perceive um COVID-19 as a less severe disease right now, even for otherwise healthy children, the possibility of long COVID as a post-infectious, long-term consequence of COVID-19 infection. is real. And, and this is something that COVID-19 brought to light, but we do, we do know that other viral infections have also long-term sequela or long-term consequences uh that we see. So, a post-viral um illness, a post viral syndrome that in the case of COVID-19, Um, does not necessarily discriminate. It's not just something that we would see in high-risk patients, but it could be otherwise healthy children of different ages, um, with different manifestations depending on the age sometimes, for example, adolescents might have more, um, behavioral or other Neurologic changes, uh, young children, uh, may not be able to articulate things, but would have, uh, also some, some symptomatology that would be usually also related to, um, dysfunction of the, of the lung, uh, system, right? So, more prolonged, um, recovery or other consequences from that. I think that, um, What we need, we, what we have learned is that um it's important to consider still long COVID and uh patients of all ages and work with your a multidisciplinary team because you would need to consider cardiologists, pulmonologists, um, people who are involved in uh Behavioral science, um, uh, neurology, uh, GI, nutrition, you know, to be able to understand and, and rheumatology as well, to be able to understand, um, what is the main impact on a particular child and what type of follow-up they need. So, um, recognizing it might be still challenging. I think it could still be in the differential diagnosis, and if we keep it in the differential diagnosis, we would know. Um, how to at least think about it. But, um, reaching out to the specialists that have dealt with long COVID through the pandemic would probably be my best advice in terms of being able to provide the proper support to manage, uh, long COVID or, you know, the sequela of COVID-19 in children. We've heard lots about myocarditis, uh, being a complication of COVID-19 infection. Can you put the risk of myocarditis post-infection into context compared to post vaccination? Yes, very important topic, because we know that COVID-19 infection itself can cause myocarditis. Actually, myopericarditis as a direct effect of the disease. And this was a serious effect of COVID-19 infection, resulting in arrhythmias, resulting in cardiac failure, thrombotic disease, just a number of complications, uh, in addition to, to just myocarditis. So, critically, um, an, an important, um, uh, manifestation of COVID-19 infection. Um, the association of myocarditis with COVID-19 vaccine was also documented. And it was noted that when you have, uh, basically a vaccine that mimics the, the infection, there could be, um, some Consequences with manifestations of myocarditis. However, when you compare a case of myocarditis post vaccine versus a case of myocarditis with an acute uh natural COVID-19 infection, The evidence has shown that post-vaccine myocarditis was always a much, much milder disease that uh was self-limited and resolved completely in patients who had the consequence uh from vaccination. So, I think that an important point to make is that the myocarditis seen post COVID-19 is much more severe with long consequences compared to any potential for myocarditis from a, from a vaccination. I will also say that the risk of myocarditis in general. Either from vaccination or from infection with COVID-19 or any other cause is very much typical of um a certain group and those would be uh young adults, adolescent to young adults, and males in, in general. That's where