Aim To study the clinical profile and outcomes in children with multisystem inflammatory syndrome in children (MIS‐C). Methods Children aged 1 month to 15 years presenting with MIS‐C (May 2020 to November 2021) were enrolled. Clinical, laboratory, echocardiography parameters and outcomes were analysed. Results Eighty‐one children (median age 60 months (24–100)) were enrolled. Median duration of fever was 5 days (3–7). Twenty‐nine (35.8%) had shock (severe MIS‐C) including 23 (28.3%) requiring inotropes (median duration = 25 h (7.5–33)). Ten required mechanical ventilation, 12 had acute kidney injury and 1 child died. Left ventricular (LV) dysfunction was seen in 38 (46.9%), 16 (19.7%) had coronary artery abnormalities (CAA) and 13 (20%) had macrophage activation syndrome. Sixty‐one (75.3%) were SARS CoV‐2 positive (10 by RT‐PCR and 51 by serology). Sixty‐eight (83.9%) received immunomodulators. Younger age was significantly associated with CAA (P value = 0.05). Older age, LV dysfunction, SARS CoV‐2 positivity, low platelet count and elevated serum ferritin were significantly associated with severe MIS‐C (univariate analysis). Younger age was an independent predictor of CAA (P = 0.05); older age (P = 0.043) and low platelet count (P = 0.032) were independent predictors of severe MIS‐C (multivariate logistic regression analysis). Conclusion Our patients had diverse clinical manifestations with a good outcome. Younger age was significantly associated with CAA. Older age, LV dysfunction, low platelet count and elevated serum ferritin were significantly associated with severe MIS‐C. Younger age is an independent predictor of CAA. Older age and low platelet count are independent predictors of severe MIS‐C.

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Background:Almost all presently available pediatric echocardiography Z-score nomograms are based on Western data. They may not be a suitable reference standard for assessing the sizes of cardiac structures of children from developing countries.Objective:This study's objective was to collect normative data of 21 commonly measured cardiovascular structures using M-mode and two-dimensional echocardiography in Indian children aged between 4 and 15 years and to derive Z-score nomograms for each.Subjects and Methods:The study was conducted at two centers in India - Ajmer, Rajasthan, and Mohali, Punjab. We studied a community-based sample involving healthy school going children. After excluding children with cardiovascular abnormalities on the screening echocardiogram, 746 children were included in the final analysis. Echocardiographic assessment was performed using a Philips iE33 system.Results and Analysis:For each parameter measured, seven models were evaluated to assess the relationship of that parameter with the body surface area and the one with the best fit was used to plot the Z-score chart for that parameter. Z score charts were thus derived.Conclusions:The Z-score nomograms derived by this study may be better alternatives to the Western nomograms for use in India and other developing countries for preprocedural decision making in the pediatric population. However, they will require validation in large-scale studies before they can become clinically applicable.

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