Incidence and Prevalence of Multisystem Inflammatory Syndrome in Children (MIS-C) in Southern Italy

Torre, Francesco La; Elicio, Maria Pia; Monno, Viviana Anna; Chironna, Maria; Moramarco, Fulvio; Campanozzi, Angelo; Civino, Adele; Cecinati, Valerio; Vairo, Ugo; Giordano, Mario; Milella, Leonardo; Loconsole, Daniela; Cardinale, Fabio

doi:10.3390/children10050766

Cited by 7 publications

(4 citation statements)

References 45 publications

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“…However, our findings are subject to several limitations. First, while our sample size is larger than some of the previous studies, 38,39 it remains relatively small, which may limit the generalizability of our findings and precluded us from performing a more comprehensive, multivariate analysis. Second, we may have overestimated the MIS-C incidence due to underreporting of mild/asymptomatic pediatric COVID-19 cases, especially during the Omicron period when contact tracing was less rigorous.…”

Section: T a B L E 3 (Continued)mentioning

confidence: 88%

Epidemiology, clinical characteristics and outcomes of multisystem inflammatory syndrome in children

Chun‐Ern Ng,

Liew,

Tan

et al. 2023

Pediatrics International

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BackgroundWe describe the epidemiology, clinical characteristics, and outcomes of multisystem inflammatory syndrome in children (MIS‐C) among children from Negeri Sembilan, Malaysia.MethodsA retrospective, multicentre, observational study was performed among children ≤15 years old who were hospitalized for MIS‐C between January 18, 2021 and June 30, 2023. The incidence of MIS‐C was estimated using reported SARS‐CoV‐2 cases and census population data. Descriptive analyses were used to summarize the clinical presentation and outcomes.ResultsThe study included 53 patients with a median age of 5.7 years (IQR 1.8–8.7 years); 75.5% were males. The overall incidence of MIS‐C was approximately 5.9 cases per 1,000,000 person‐months. Pediatric intensive care unit (PICU) admission was required for 22 (41.5%) patients. No mortalities were recorded. Children aged 6–12 years were more likely to present with cardiac dysfunction/shock (odds ratio [OR] 5.43, 95% confidence interval [CI] 1.67–17.66), whereas children below 6 years were more likely to present with a Kawasaki disease phenotype (OR 5.50, 95% CI 1.33–22.75). Twenty patients (37.7%) presented with involvement of at least four organ systems, but four patients (7.5%) demonstrated single‐organ system involvement.ConclusionAn age‐based variation in the clinical presentation of MIS‐C was demonstrated. Our findings suggest MIS‐C could manifest in a spectrum, including single‐organ involvement. Despite the high requirement for PICU admission, the prognosis of MIS‐C was favorable, with no recorded mortalities.

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Section: T a B L E 3 (Continued)mentioning

confidence: 88%

Epidemiology, clinical characteristics and outcomes of multisystem inflammatory syndrome in children

Chun‐Ern Ng,

Liew,

Tan

et al. 2023

Pediatrics International

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“…The reported incidence of MAS was 1.9% (12/638) for KD, 3.2% (8/247) for incomplete KD, 4.8% (3/63) for KDSS, and 6.3% (4/63) for refractory KD [ 22 ]. In patients with MIS-C, the incidence of MAS has been reported to be much higher at 22.7% (5/22) [ 6 ], 42.1% (8/19) [ 9 ], and 50.0% (5/10) [ 3 ]. Rodriguez-Smith et al [ 9 ] reported that patients with MIS-C who met the 2016 MAS criteria had significantly higher levels of interferon-related chemokines than did patients with MIS-C who did not meet the 2016 MAS criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Soon after, similar cases began to be reported in the United Kingdom, Spain, France, the United States, India, Brazil, and many other countries, including Korea [ 2 , 4 ]. The condition is now called COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome temporarily related to SARS-CoV-2 (PIMS-TS) [ 4 , 5 , 6 ]. MIS-C is a serious complication that can occur two to eight weeks after SARS-CoV-2 infection and is characterized by infectious triggers, systemic inflammation, and organ dysfunction [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Similarities and Differences between Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki Disease Shock Syndrome

Lee,

Kim,

Cho

et al. 2023

Children

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This study aimed to investigate the characteristics of COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease shock syndrome (KDSS) and to compare the similarities and differences between the two diseases. The incidence of KDSS and MIS-C was also estimated. Medical records of patients diagnosed with MIS-C or KDSS at four hospitals from January 2013 to December 2022 were retrospectively reviewed. Thirty-one patients were enrolled in the study in either an MIS-C group (n = 22) or a KDSS group (n = 9). The incidence of KDSS in KD was 0.8% (9/1095) and the incidence of MIS-C versus KD was 10.2% (22/216). Compared with the MIS-C group, the KDSS group had longer hospital stays and more severe systemic inflammation (e.g., anemia, elevated C-reactive protein, hypoalbuminemia, and pyuria) and organ dysfunction (e.g., number of involved organs, shock, vasoactive infusion, and intensive care unit admission). All patients in the MIS-C group, but none in the KDSS group, including two patients during the COVID-19 pandemic, had laboratory evidence of SARS-CoV-2 infection. MIS-C and KDSS shared demographic, clinical, and laboratory characteristics; organ dysfunction; treatment; and outcomes. Overall severity was more severe in patients with KDSS than in those with MIS-C. The most important difference between MIS-C and KDSS was whether SARS-CoV-2 was identified as an infectious trigger.

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“…The first epidemiological study of MIS-C in Europe showed a cumulative incidence of 3.27 per 100,000 inhabitants and a prevalence of 74 cases per 100,000 pediatric subjects with previous SARS-CoV-2, between 0 and 18 years of age. A higher incidence of gastrointestinal and cardiac involvement has been demonstrated with myocarditis compared with Kawasaki disease [13].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Manifestations of Multisystem Inflammatory Syndrome in Children: A Single-Center Bulgarian Study

Mileva,

Vasilev,

Ganev

et al. 2023

Medicina

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Background and objectives: Multisystem inflammatory syndrome in children (MIS-C) poses challenges to the healthcare system, especially with frequent heart involvement. The current retrospective observational study aims to summarize the type and degree of cardiovascular involvement in children with MISC and to find possible associations between laboratory, inflammatory, and imaging abnormalities and the predominant clinical phenotype using a cluster analysis. Material and methods: We present a retrospective observational single-center study including 51 children meeting the MIS-C criteria. Results: Fifty-three percent of subjects presented with at least one sign of cardiovascular involvement (i.e., arterial hypotension, heart failure, pericardial effusion, myocardial dysfunction, pericarditis without effusion, myocarditis, coronaritis, palpitations, and ECG abnormalities). Acute pericarditis was found in 30/41 of the children (73%) assessed using imaging: 14/30 (46.7%) with small pericardial effusion and 16/30 (53.3%) without pericardial effusion. The levels of CRP were significantly elevated in the children with pericarditis (21.6 ± 13 mg/dL vs. 13.9 ± 11 mg/dL, p = 0.035), and the serum levels of IL-6 were higher in the children with small pericardial effusion compared to those without (191 ± 53 ng/L vs. 88 ± 27 ng/L, p = 0.041). Pericarditis with detectable pericardial effusion was significantly more frequent in the female vs. male subjects, 72% vs. 30% (p = 0.007). The hierarchical clustering analysis showed two clusters: Cluster 1 includes the children without cardiovascular symptoms, and Cluster 2 generalizes the MIS-C children with mild and severe cardiovascular involvement, combining pericarditis, myocarditis, heart failure, and low blood pressure. Also, subjects from Cluster 2 displayed significantly elevated levels of fibrinogen (5.7 ± 0.3 vs. 4.6 ± 0.3, p = 0.03) and IL-6 (158 ± 36 ng/mL vs. 66 ± 22 ng/mL, p = 0.032), inflammatory markers suggestive of a cytokine storm. Conclusions: Our results confirm that children with oligosymptomatic MIS-C or those suspected of long COVID-19 should be screened for possible cardiological involvement.

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Incidence and Prevalence of Multisystem Inflammatory Syndrome in Children (MIS-C) in Southern Italy

Cited by 7 publications

References 45 publications

Epidemiology, clinical characteristics and outcomes of multisystem inflammatory syndrome in children

Epidemiology, clinical characteristics and outcomes of multisystem inflammatory syndrome in children

Similarities and Differences between Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki Disease Shock Syndrome

Cardiovascular Manifestations of Multisystem Inflammatory Syndrome in Children: A Single-Center Bulgarian Study

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