Background: In April 2020, a novel syndrome termed multisystem inflammatory syndrome in children (MIS-C), related to SARS-CoV-2 infection was first described. This syndrome has a wide spectrum of systemic involvement, has shown to include the nervous system as well. Our study aims to obtain a baseline clinical and demographic profile of varied neurological manifestations of MIS-C. It also aims to delineate a profile of short-term outcome in these patients with regards to residual neurological sequelae.
Methods: A single-centre, retrospective, observational and hospital based study for 5 months was conducted among patients in the age group from 1 month to 12 years, with MIS-C with co-existing neurological symptoms. The subjects who had pre-existing neurological diseases were excluded from the study. A total of 34 subjects were collected. Post-discharge, each patient was followed up for a period of 1 month. The residual neurological deficits, if any, at discharge and follow-up.
Results: The neurological complication found were Acute Symptomatic Seizure (29.4%), Aseptic Meningitis (23.5%), Encephalitis (11.8%), Guillain-Barré Syndrome (11.8%), Miller-Fisher Syndrome (2.9%), ADEM (8.8%), Autoimmune Encephalitis (8.8%) and Acute Haemorrhaegic Stroke (2.9%). 11.8% expired and 50% required P.I.C.U admissions. 23.5% had residual neurological deficit at discharge and 8.8% at follow-up after 1 month of discharge.
Conclusions: In spite of great variability in manifestations, prognosis is favourable if early aggressive treatment is initiated.
In April 2020, a novel syndrome in children and adolescents, termed multisystem inflammatory syndrome in children (MIS-C), related to SARS-CoV-2 (severe acute respiratory syndrome corona virus 2) infection was first described in the United Kingdom and Italy. In this case series, we analysed 6 patients who had moderate to severe respiratory system manifestations at presentation, closely resembling the acute infection. A retrospective analysis of 6 pediatric patients, diagnosed as MIS-C, presenting with predominant respiratory system manifestations between December 2020 to October 2021 was undertaken. All the 6 patients presented with fever and predominant respiratory symptoms which mainly included difficulty in breathing, while two patients had accompanying chest pain. Gastrointestinal symptoms were found to be the most common accompanying systemic involvement. The inflammatory markers were found to be deranged in all the patients. COVID-19 RT-PCR was negative and serology for COVID-19 IgG was positive in all the patients. All the patients were successfully discharged. All were followed up 1 month after discharge. Residual respiratory morbidity was found in none of them. Our case series highlights the importance of distinguishing active covid-19 infection from MIS-C especially in the setting of overlapping clinical features. Timely diagnosis of MIS-C will also prevent unnecessary antibiotic usage.
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