A Comparative Study of Children with MIS-C between Admitted to the Pediatric Intensive Care Unit and Pediatric Ward: A One-Year Retrospective Study

Abstract

Objectives This descriptive study aimed to compare the clinical and laboratory features of the children with the multisystem inflammatory syndrome in children (MIS-C), requiring pediatric intensive care unit (PICU), admission with the MIS-C patients who did not require PICU admission. Patients and methods This study was conducted between March 2020 and February 2021 at the University of Health Sciences Dr. Behçet Uz Children’s Hospital, a referral center for pediatric infectious diseases in the Aegean Region of Turkey. All hospitalized patients aged 18 years old or less with MIS-C according to the definition of the universal guidelines were included in the study. Data of the patients with the diagnosis of MIS-C were recorded and collected from the electronic medical records of the hospital. The data included demographic characteristics, presenting signs and symptoms, laboratory findings and clinical data. Results A total of 58 patients with MIS-C were included in this study. Thirty-eight (65.5%) patients were male. The median age was 6 years (2 months–16 years). The patients admitted to PICU were 15 (25.9%). The rate of pulmonary involvement was 81.3% (n = 13) in the PICU group. The median procalcitonin, C-reactive protein, erythrocyte sedimentation rate, D-Dimer and ferritin values were significantly higher in the PICU group compared to non-PICU group (p < 0.001, p = 0.02, p < 0.001, p = 0.006 and p = 0.031). Conclusions Besides the depressing cardiac functions reported before, the pulmonary involvement and signs of shock are important factors for PICU admission in children with MIS-C.

Clinical and epidemiological features and severity markers in children admitted with multisystem inflammatory syndrome in children (MISC) in a tertiary care center in the United Arab Emirates

“…Our study demographics showed children admitted in PICU for MISC were significantly older than the children admitted with MISC in general pediatric wards. This is consistent with other studies about MISC in the literature, making older age a possible risk factor for severity of MISC 15 …”

“…In concordance with multiple other studies, our study established shock and hypotension as a significant indication for PICU admission. 15,16…”

Evaluation of Multisystem Inflammatory Syndrome in Children (MIS-C) Cases: Clinical Features and Cardiologic Findings

“…The rate of admission to the intensive care unit ranges from 30% to 80% in different studies (7,(12)(13)(14). In our country, the rates of admission to the ICU were reported to be 37.6% by Yılmaz-Çiftdoğan et al, 25.9% by Kıymet et al, and 31.3% by Sözeri et al (14)(15)(16).…”

“…Regarding laboratory findings, CRP, D-dimer, ferritin, and pro-BNP levels were reported to be higher (11). In another study conducted in our country, no association was found between gastrointestinal, cardiac, and neurological system involvement and ICU admission; however, it was found that patients with respiratory system findings and hypotension required more intensive care at the time of admission (14). Similar to previous studies, the average age of patients requiring intensive care was higher in our study, whereas hypotension, tachycardia, and cardiogenic shock were more common.…”

Efficacy of sildenafil and high-dose anakinra in an MIS-C patient with pulmonary vasculitis: A case report

“…Since the first phase of the COVID-19 outbreak, a new childhood multi-inflammatory syndrome temporally linked with SARS-CoV-2 infection has been reported worldwide. It has some similarities with Kawasaki disease (KD) and toxic shock syndrome (TSS) ( 1 , 2 ). This condition has been named pediatric inflammatory multisystem syndrome temporally associated to SARS-CoV-2 infection (PIMS-TS) or multisystem inflammatory syndrome associated with coronavirus disease 2019 (MIS-C) ( 3 – 7 ).…”