A Madison County 7-year-old boy, Gus Boykin, is recovering from complications from COVID-19 that required a stay at Scottish Rite. And his father, Bo Boykin, the CEO of the Broad River College and Career Academy and the CTAE (Career, Technical and Agricultural Education) Director for the Madison County School System, answered questions from The Journal about his son’s condition, with the intent of giving county residents some knowledge about a potential complication children with COVID-19 can have.
Here is that interview:
•When did your family first have a positive in your house? Who in your family has had it and what was that experience like?
We all tested positive. I was the first one in our household to test positive on July 29. Gus tested positive on Aug. 3. Glenn and Mary tested positive on a later date. My symptoms were similar to the flu (fever, headache, fatigue). I also lost my sense of smell. Mary's symptoms were like a bad cold and she also lost her sense of smell. Gus had a high fever for one day and slept most of the day. Glenn only had a sore throat for a few days.
•You mentioned that Gus had the virus and then began having complications about a month later. Can you describe the symptoms?
He had COVID symptoms for only one day on Aug. 2. On Aug. 28, he started to run a high fever (103-104) and vomiting. This continued over the weekend. He could not keep anything down and his fever remained in the 103-104 range. We thought it was a stomach virus. We brought him to the pediatrician on Monday morning and she thought it was walled-off appendicitis. Due to signs of dehydration, we were sent to Piedmont for IV fluids and testing. When the appendix was ruled out, which surprised the doctor, she ordered additional tests. Those additional blood tests showed signs of inflammation throughout his body. Our pediatrician, Dr. Holly Aldridge, suspected that it could be MIS-C, which stands for multisystem inflammatory syndrome in children, since he had contracted COVID several weeks before. He was also beginning to have some of the more odd signs of MIS-C — red fingertips, bright red lips and tongue, and red eyes.
•You mentioned the condition that was diagnosed. Can you tell me about that and how doctors determined that was what Gus had? Doctors were certain it was a complication from coronavirus?
The night he was at Piedmont, he was transported via ambulance to Scottish Rite. The doctor there diagnosed with MIS-C. Basically, they have to have a fever, lab evidence of inflammation, and clinically severe illness requiring hospitalization with multisystem organ involvement. Also, they must have had exposure or a confirmed case of COVID-19 within four weeks prior to the onset of symptoms to meet the diagnosis. The condition is similar to Kawasaki Disease, but MIS-C is the COVID-related version and it manifests itself a little differently.
•How long was Gus at Scottish Rite? What were they monitoring? What was the good news that let them know he was OK to release?
Gus was at Scottish Rite for seven days. They were monitoring his visible symptoms (red fingertips, red lips, red eyes, rash on his back), his fever, his blood work for signs of inflammation, his gastric issues, his clotting factors, and echocardiograms for heart function. MIS-C can also cause issues with blood clots. To avoid this, Gus was given anticoagulant injections in his stomach, which unfortunately caused issues with frequent nosebleeds. Soon before Gus received his first treatment, his heart-related indicators began to go up which was very concerning. After the first treatment (IVIG), he showed some improvement and the inflammation leveled off. Receiving the IVIG was a little stressful. It's done via IV over the course of 12 hours and vitals are taken hourly. After several days, he was given a second treatment (high-dose steroids) and his indicators began to trend downward. They felt comfortable releasing him when his fever stayed down for several days, his redness began to go away, and the blood work continued to show improvement.
•Are there any lingering effects now? Does he feel back to normal? What sort of monitoring continues? Do doctors feel this will carry any long-term effects?
Gus is doing much better now. He was very weak for some time after he left the hospital. We were advised to avoid his contact with others for a week to minimize the risk of another illness causing the inflammation to come back. He's since finished up his antibiotics and oral steroids. He'll be on a baby aspirin until mid-October. That helps with blood clots and reducing inflammation. Since leaving the hospital, Gus has had numerous follow-up appointments with infectious disease, cardiology, ENT, and hematology doctors to monitor his condition. He will be monitored by the cardiologist for six months. Since MIS-C did not exist before the spread of COVID-19, little is known about possible long-term effects. If it follows the long-term patterns of Kawasaki Disease, it is very unlikely to reoccur, but we were told to keep the possibility of a recurrence in the back of our minds until he is 20-years-old.
•Can you tell me a little about Gus? What hobbies does he have? How has he handled this experience? It has surely been a challenge for him to process all this. How long has he been back at school and how is that going? What grade is he in?
Gus is a 7-year-old second grader at Ila Elementary. He loves playing video games, taking care of his pets, playing with his friends, and playing in the woods. He likes to swim, play golf, and he especially loves to talk. Gus handled a challenging situation very well. He had to have blood drawn every morning at 5 a.m. and painful injections in his stomach daily. He did not feel well enough to eat or drink for a week. He has never taken a pill, but he learned how in the hospital when he really did not feel well. We are very proud of how he handled it. He went back to school a week after being released from the hospital and he is doing well getting caught up. The school and his teacher have been so understanding and supportive.
•Does Gus have anything he wants to say about all this?
Gus said he wanted others to know that being in the hospital was not so bad. He wants to thank all the doctors and nurses who were so nice to him when he was sick.
•How are you and your wife emotionally now? This is such a tough thing to go through. I hope you’re both doing OK.
We are doing well now. It was a very difficult and scary experience. I have never seen Gus so sick and I really felt helpless. We prayed a lot and we greatly appreciate all those who lifted up prayers during that time for his recovery. It was also hard for Gus' older sister, Glenn. She had to stay away from home with relatives during that time. And while it's fun to stay with her great-grandma and great-aunt, it was hard to be away from us, wondering if Gus was going to be okay. It was not until we got home that the exhaustion caught up with us, but we were very relieved that he was feeling better and we were all back at home.
•What do you want the public to understand about this condition and what y’all went through?
When we contracted and recovered from COVID-19, we thought we were in the clear. Mary had heard of MIS-C, but I never had. We want others to know that MIS-C is a very serious, possibly life-threatening, condition that can affect children who have recently had COVID-19. Gus is an active 7 year old with no underlying health conditions and it made him very sick. We are very thankful that our pediatrician was so thorough when we took Gus to see her. If she did not correctly diagnose the condition, I believe we likely would have been in the ICU a few days later and he could have suffered permanent heart or kidney damage. While data seems to show that MIS-C is a rather rare condition, we are concerned that additional cases may be out there. Based on anecdotal stories we have heard from other parents, we suspect there may be cases that have gone undiagnosed because it is so new. Gus was only the second case from the Athens area to be diagnosed with MIS-C.
What the CDC says about MIS-C
Patients with MIS-C have presented with a persistent fever, fatigue, and a variety of signs and symptoms, including multi-organ (e.g., cardiac, gastrointestinal, renal, hematologic, dermatologic, neurologic) involvement and elevated inflammatory markers.
Not all children will have the same signs and symptoms, and some children may have symptoms not listed here.
MIS-C may present weeks after a child is infected with SARS-CoV-2. The child may have been infected from an asymptomatic contact and, in some cases, the child and their caregivers may not even know they had been infected.
Report possible cases of MIS-C to your local, state, or territorial health department.
Visit cdc.gov/mis-c/hcp for more information and a case report form.
Questions? Contact CDC’s 24-hour Emergency Operations Center at 770-488-7100.