Clinical features and outcome of MIS-C patients: an experience from Central Anatolia

Abstract

Background Multisystem inflammatory syndrome in children (MIS-C) is a new clinical condition characterized by signs of inflammation and multiorgan dysfunction due to cytokine storm associated with SARS-CoV-2. The clinical spectrum of MIS-C ranges from mild to severe, and even to mortal multisystem involvement. To guide clinicians, we evaluated detailed demographic characteristics, clinical features, laboratory findings, and outcomes of MIS-C cases. Methods We performed a retrospective study of patients with MIS-C who were managed in the Department of Pediatric Infectious Disease in the Selcuk University Faculty of Medicine, Konya, Turkey. MIS-C patients were divided into three clinical severity groups (mild, moderate, and severe) and separated into three age groups (< 5 years, 5–10 years, > 10 years). We compared the characteristics of MIS-C cases according to the severity of the disease and by age groups. Result Thirty-six children with MIS-C were evaluated (52.8% male, median age of 7.8 years). A clinical spectrum overlapping with Kawasaki disease (KD) was the most common presentation (69.4%) in all age groups. The most common clinical symptoms were fever (100%), mucocutaneous rash (69.4%), and gastrointestinal symptoms (66.6%). There was no statistically significant difference in echocardiographic abnormality between KD-like and the other clinical spectra ( p > 0.05). All life-threatening rhythm disturbances were observed in severe cases. No patients died. Conclusion It is important to increase the awareness of physicians about the MIS-C disease, which can present with different combinations of different systemic findings, so that patients can be diagnosed and treated in a timely manner. Key Points • A single tertiary centre study shows that children with MIS-C can present with different clinic spectra other than Kawasaki diseases . • Electrocardiographic and echocardiographic evaluation is important in early diagnosis of children with MIS-C. • Pro-BNP can be used as a screening test in the emergency room for children with prolonged and unexplained fever for determine early cardiac involvement of MIS-C. • The lack of require biological agents and favourable outcomes in children with MIS-C may be related with administration of steroid therapy with IVIG in early stage of disease.

Worldwide epidemiology of neuro-coronavirus disease in children: lessons for the next pandemic

“…In the broader published pediatric literature, neurological manifestations such as smell/taste disorders, headache, seizures, and stroke appear to predominate in acute COVID-19, whereas headache, encephalopathy, and MRI changes suggesting neuroinflammation predominate in MIS-C. Examples of neurological manifestations in children reported to date are summarized by clinical phenotype in Table 1 [ 60 , 61 , 62 ▪▪ , 63 ▪ , 64 , 65 ▪ , 66 , 67 ▪ , 68 – 75 , 76 ▪ , 77 , 78 ▪ , 79 , 80 ▪▪ ]. As these studies represent different pediatric cohorts (e.g.…”

Multisystem Inflammatory Syndrome in Children (MIS-C) with COVID-19: A Single-Center Experience

“…Similar to our study, previous studies have reported that most children with MIS-C are aged between 6 and 9 years. 2,11,16,17 Patients participating in the study were admitted to the hospital on an average of 4 days after the onset of symptoms, and the mean hospital stay was 11 days, similar to the studies in the literature. 16,18 In the study by Feldstein et al conducted in the United States involving 186 children with MIS-C, a positive rate of 31.1% was observed through serologic tests.…”

Multisystem Inflammatory Syndrome in Children Associated with COVID-19 Infection: A Comprehensive Review

“…Table 3 presents a summary of the frequency of clinical findings for patients presenting with MIS-C based on a review of case reports 2 28 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 and observational studies, 12 43 67 68 69 70 71 72 73 74 75 76 77 78 79 80 Regarding Kawasaki-like symptoms, the most frequent was fever for ≥3 days in 690/694 (99.4%) of cases. Rash (388/694 [55.9%]) and bilateral conjunctivitis (370/694 [53.3%]) were present in just over half of the patients, while cervical adenopathy (69/694 [9.9%]), mucosal changes (29/694 [4.2%]), and peripheric edema (68/694 [9.8%]) were less commonly noted.…”

“…Overlap between two or more clusters was seen in some cases, but its occurrence was minimal. 47 ►Table 3 presents a summary of the frequency of clinical findings for patients presenting with MIS-C based on a review of case reports 2,28,48-66 and observational studies, 12,43,[67][68][69][70][71][72][73][74][75][76][77][78][79][80] Regarding Kawasaki-like symptoms, the most frequent was fever for !3 days in 690/694 ( Overall, reports do allow some comparison between MIS-C and KD. 69,77 Patients with KD tend to be younger and present more frequently with cervical adenopathy and mucocutaneous changes in the extremities and oral cavity.…”