Covid-19 Story Tip: Teen Survives Life-threatening Battle with Inflammatory Disease Associated with COVID-19

02/24/2021

A few days before her 18th birthday in November, Tyona Montgomery’s throat started to hurt. Eventually, testing showed she had COVID-19. Later, she lost her sense of smell. She quarantined at home, and her symptoms went away. A few weeks later, her head, eyes and body ached, and she became disoriented, so she went to a local hospital and was admitted. While there, she had a fever, her heart was beating abnormally fast, her breathing was labored, she began vomiting, and her eyes and lips became red. Soon, Tyona’s major organs appeared to be shutting down, and she was quickly transferred to Johns Hopkins Children’s Center. Upon arrival, Tyona’s heart function — her ability to pump blood — was severely diminished, and doctors, nurses and clinical team members rushed to save her. 

It was at Johns Hopkins that Tyona’s mother, Kristia Reynolds, was told that her daughter had multisystem inflammatory syndrome in children, (MIS-C), a condition that results in widespread inflammation of various organs including the heart, lungs, kidneys, blood, brain, skin, eyes and gastrointestinal tract. The exact cause of MIS-C is not known, but it is understood to be an inflammatory response following exposure to COVID-19, whether after a personal illness or contact with someone with COVID-19. MIS-C is not an active COVID-19 infection but is the exaggerated inflammatory illness that develops weeks after the COVID-19 exposure. According to the Centers for Disease Control and Prevention, more than 2,000 children and adolescents in the U.S. have been diagnosed with MIS-C associated with COVID-19 since May 2020 in the United States. Doctors are trying to determine why some children and adolescents develop the condition and others do not.

The clinical team at Johns Hopkins was able to stabilize Tyona in the pediatric intensive care unit. She received bilevel positive airway pressure (BiPAP) — a treatment using a type of breathing machine — and additional oxygen to support her breathing. Her MIS-C condition required a cocktail of medication, including intravenous medicines to help her heart pump and to reduce the inflammation. This included high doses of steroids and the anti-inflammatory medication anakinra. Eventually she was transitioned off BiPAP and weaned off oxygen. 

While at Johns Hopkins Children’s Center, Tyona suffered a seizure — her first ever. Her doctors believe MIS-C may have caused it. Soon, however, she was well enough to be weaned off most of her medications, and after nine days at the Children’s Center — on Christmas Eve — Tyona was able to go home. Her heart function has since returned to normal, but doctors at Johns Hopkins Children’s Center are still monitoring her. 

“Tyona presented with a severe case of MIS-C with significant cardiac dysfunction. The fact that she is alive is an incredible feat,” says Ekemini Ogbu, M.B.B.S., M.Sc., pediatric rheumatologist at Johns Hopkins Children’s Center and assistant professor of pediatrics at the Johns Hopkins University School of Medicine. Ogbu is among the doctors continuing to follow Tyona’s progress.

“We are reassured by her significantly improved cardiac function, but Tyona will require continued surveillance as we expand our knowledge of long-term cardiac effects of MIS-C,” says Lasya Gaur, M.D., Tyona’s pediatric cardiologist at Johns Hopkins Children’s Center and an assistant professor of pediatrics at the Johns Hopkins University School of Medicine. “We plan to use all the tools at our disposal, including advanced cardiac testing to monitor her cardiac status closely.”

“Right now, she has good and bad days,” her mother says. Tyona, who never had major health issues before her MIS-C diagnosis. She still gets winded easily and has dizziness and little appetite. Since research is still being done on the long-term effects of MIS-C, it’s unclear how long these symptoms could last for Tyona. 

Tyona, who loves art, fashion, makeup and singer-songwriter Justin Bieber, isn’t allowing MIS-C to interfere with her future aspirations. “I want to have my own business,” she says.

Tyona and her mother, who works at The Johns Hopkins Hospital as a rehabilitation technician, are available to speak about their experience. Tyona’s doctors can also talk about Tyona’s case as well as MIS-C.