Clinical profile and outcome of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection: a single-center observational study from South India

Abstract

Background Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious sequelae of acute COVID-19 infection affecting children. This study was done over a period of 12 months from December 2020 to November 2021 to describe the clinical presentation, laboratory abnormalities, and outcome of children with MIS-C. Methods Seventy-eight children below 12 years of age who satisfied the WHO diagnostic criteria for MIS-C were included in the study. Clinical parameters were recorded at admission. Relevant laboratory investigations, radiological studies, and outcome were documented. Results The most commonly affected age group was 6–12 years with a female predominance. COVID RTPCR was negative in all patients. Most cases presented 2–6 weeks after the onset of acute COVID-19 infection. Lethargy, poor feeding, vomiting, abdominal pain, loose stools, cough, and cold are common symptoms of MIS-C syndrome in children and the common signs were rash, conjunctival congestion, hypotension, tachycardia, tachypnea, and hypoxemia. Gastrointestinal system was the commonly affected followed by the hepatic, renal, and cardiovascular systems. Coronary artery abnormalities were seen in 20% of cases. IVIg was the mainstay of therapy used in 95% of patients. Mortality was 1.3%. Cases responded well to IVIg and steroids. Conclusion Overall, the short-term outcome was favorable with low mortality in our study cohort. One-fifth of children had coronary artery abnormalities during acute phase underscoring the need for long-term follow-up.

Clinical profile and outcome of multisystem inflammatory syndrome in children and adolescents related to COVID-19 in a tertiary care hospital

“…Sai et al in their study mentioned that most commonly affected age group was 6 to 12 years accounting for more than 50% of the study population. 7 This finding was in agreement with other similar published studies. [8][9][10] Our study also reveals that girls were affected more than boys.…”

“…Similar finding was observed in the studies conducted by Sai et al who noticed male to female ratio of 1:1.9 and Dhanalakshmi et al who reported M:F ratio of 1:1.4. 7,11 However, most other studies showed male predisposition-Hoste et al (M:F-1.4:1 out of 928 cases), Goldfred et al (M:F-1.2:1 out of 570 cases), Sethy et al (M:F-3.2:1 out of 21 cases), Kaushik et al (M:F-1.6:1 out of 33 cases), and Sugunan et al (M:F-1.9:1 out of 32 cases). 4,8,9,13,14 Out of 24 patients, one had history of RTPCR positive report and 10 patients had history of contact with COVID positive patient.…”

Severity Predictors for Multisystemic Inflammatory in Children after SARS-CoV-2 Infection: A Prospective Observational Study from Vietnam

“…Despite being considered as a "new entity" of KD, MIS-C is common in children 9-10 years, whereas classic KD occurs predominantly in children under ve years of age 9,23,32 . In line with previous studies, our study identi ed that the median age group was 7 (3-12) years (Table 1) 26,42,43 .…”

“…MIS-C might present with a heterogeneous spectrum in severity, ranging from mild manifestations to severe complications, including shock, respiratory failure, myocardial involvement, multiorgan dysfunction, coagulopathy, and encephalopathy 11,15,19,23,24 . Considering the possibility of acutely and aggressively worsening to life-threatening conditions of this novel syndrome, identi cation of predictors for the at-risk patients is crucial for more strict monitoring and appropriate treatment.…”

“…To date, despite the ongoing efforts to investigate any independent factors that could predict the severity and outcomes of the disease, data on this issue still lacks consistency. Additionally, regardless of the evolution of data from North America and European countries, there are few reports on MIS-C from Asia, leading to an underestimated disease burden in this area 9,10,11,12,16,23 . Vietnam has experienced the fourth COVID-19 wave of epidemics, of which the fourth wave from early 2021 had been by far the worst of the pandemic 29,30 .…”