Multisystem Inflammatory Syndrome and COVID-19 in children and adolescents: epidemiological aspects, Brazil, 2020-20211

Moura, Erly Catarina de; Cavalcante, Fabrício Vieira; Oliveira, Luciana Gonzaga de; Barreto, Ivana Cristina de Holanda Cunha; Fernandes, Geraldo Magela; Frio, Gustavo Saraiva; Santos, Leonor Maria Pacheco

doi:10.1590/0103-1104202213406i

Cited by 1 publication

(2 citation statements)

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“…However, these studies were limited to secondary public domain data (the Ministry of Health's epidemiological bulletins), had a much lower number of patients, and were restricted to those attending pediatric intensive care units. [14][15][16][17][18][19] Although most clinical and epidemiological characteristics of our patients were similar to those of other MIS-C cohorts, [20][21][22][23][24] our research highlights some marked differences. We described particularly severe cases in which almost three-quarters (73.3%) were admitted to the PICU.…”

Section: Discussionmentioning

confidence: 56%

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High Fatality Rates in Pediatric Multisystem Inflammatory Syndrome: A Multicenter Experience From the Epicenter of Brazil’s Coronavirus Pandemic

Almeida,

Jarovsky,

Almeida Farias

et al. 2023

Pediatric Infectious Disease Journal

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Background: Brazil´s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children. Methods: We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of São Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables. Results: A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants. Conclusion: We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.

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Section: Discussionmentioning

confidence: 56%

“…However, these studies were limited to secondary public domain data (the Ministry of Health’s epidemiological bulletins), had a much lower number of patients, and were restricted to those attending pediatric intensive care units. 14–19…”

Section: Discussionmentioning

confidence: 99%