Multicenter cohort study of multisystem inflammatory syndrome in children (MIS-C)

Merckx, Joanna; Cooke, Suzette; Tal, Tala El; Laxer, Ronald M.; Bitnun, Ari; Morris, Shaun K.; Yeh, E. Ann; Yea, Carmen; Gill, Peter; Papenburg, Jesse; Lefebvre, Marie-Astrid; Ulloa‐Gutiérrez, Rolando; Brenes-Chacón, Helena; Yock‐Corrales, Adriana; Ivankovich‐Escoto, Gabriela; Soriano-Fallas, Alejandra; Mezerville, Marcela Hernández-de; Dewan, Tammie; Restivo, Léa; Nateghian, Alireza; Aski, Behzad Haghighi; Manafi, Ali; Dwilow, Rachel; Bullard, Jared; Lopez, Alison; Sadarangani, Manish; Roberts, Ashley; Barton, Michelle; Petel, Dara; Saux, Nicole Le; Bowes, Jennifer; Purewal, Rupeena; Lautermilch, Janell; Tehseen, Sarah; Bayliss, Ann; Wong, Jacqueline; Leifso, Kirk; Foo, Cheryl Wong Po; Robinson, Joan

doi:10.1101/2021.05.14.21257058

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…To our knowledge, this is the third published case series of MIS-C in Canada ( 10 , 11 ) and the presentation of our cohort is in keeping with existing literature ( 10 , 12–14 ). Patients with confirmed MIS-C commonly presented with gastrointestinal (GI) and mucocutaneous symptoms, but at a rate comparable to the ruled-out group.…”

Section: Discussionsupporting

confidence: 87%

All hands on deck: A multidisciplinary approach to SARS-CoV-2-associated MIS-C

Lopez

Patel

Rayment

et al. 2022

Paediatrics &Amp; Child Health

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Background Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of SARS-CoV-2 infection with overlapping features of Kawasaki disease and toxic shock syndrome. In May 2020, a provincial multidisciplinary working group was established in anticipation of emerging cases following the first wave of SARS-CoV-2 infections. Methodology Our centre established a multidisciplinary working group for MIS-C cases in British Columbia. The group developed guidelines using the World Health Organization MIS-C case definition. Guidelines were updated using quality improvement methods as new reports and our local experience evolved. We included all children who were evaluated in person or had samples sent to our centre for MIS-C evaluation from May 2020 to April 2021. We prospectively collected patient demographics, clinical and laboratory characteristics, and treatment. Results Fifty-two children were included. Eleven were diagnosed as confirmed MIS-C. Ten of the 11 MIS-C cases presented with shock. Gastrointestinal and mucocutaneous involvement were also prominent. Common laboratory features included elevated C-reactive protein, D-dimer, troponin, and brain natriuretic peptide. Four out of 11 (36%) had myocardial dysfunction and 3/11 (27%) had coronary artery abnormalities. All 11 patients had evidence of SARS-CoV-2 infection. Ten out of 11 (91%) received intravenous (IV) immunoglobulin and IV corticosteroids. Conclusion Our provincial cohort of MIS-C patients were more likely to present with shock and cardiac dysfunction, require ICU admission, and be treated with corticosteroids compared to ruled out cases. Our working group’s evolving process ensured children with features of MIS-C were rapidly identified, had standardized evaluation, and received appropriate treatment in our province.

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Section: Discussionsupporting

confidence: 87%

All hands on deck: A multidisciplinary approach to SARS-CoV-2-associated MIS-C

Lopez

Patel

Rayment

et al. 2022

Paediatrics &Amp; Child Health

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“…Epididymitis was seen in only 1 study subject. In a multi-center cohort study, 1 out of 232 children of MIS-C developed epididymitis [19].…”

Section: Discussionmentioning

confidence: 99%

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

Sai

Kumar

Babu

et al. 2023

Egypt Pediatric Association Gaz

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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.

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“…Seventeen pediatric hospitals (15 Canadian and one each in Iran and Costa Rica) included children up to 17 years of age admitted February 1, 2020, through May 31, 2021, with detection of SARS-CoV-2. Methods are fully described in our previous report [ 3 ]. Following ethics approval at all sites, data were extracted into REDCap (Research Electronic Data Capture) tools hosted at the University of Alberta [ 4 ] from medical records by physician investigators or research assistants supervised by investigators.…”

Section: Methodsmentioning

confidence: 99%

SARS-CoV-2 infection in technology-dependent children: a multicenter case series

et al. 2022

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Purpose The objective of this study was to describe the clinical course and outcomes in children with technology dependence (TD) hospitalized with SARS-CoV-2 infection. Methods Seventeen pediatric hospitals (15 Canadian and one each in Iran and Costa Rica) included children up to 17 years of age admitted February 1, 2020, through May 31, 2021, with detection of SARS-CoV-2. For those with TD, data were collected on demographics, clinical course and outcome. Results Of 691 children entered in the database, 42 (6%) had TD of which 22 had feeding tube dependence only, 9 were on supplemental oxygen only, 3 had feeding tube dependence and were on supplemental oxygen, 2 had a tracheostomy but were not ventilated, 4 were on non-invasive ventilation, and 2 were on mechanical ventilation prior to admission. Three of 42 had incidental SARS-CoV-2 infection. Two with end-stage underlying conditions were transitioned to comfort care and died. Sixteen (43%) of the remaining 37 cases required increased respiratory support from baseline due to COVID-19 while 21 (57%) did not. All survivors were discharged home. Conclusion Children with TD appear to have an increased risk of COVID-19 hospitalization. However, in the absence of end-stage chronic conditions, all survived to discharge.

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Multicenter cohort study of multisystem inflammatory syndrome in children (MIS-C)

Cited by 7 publications

References 26 publications

All hands on deck: A multidisciplinary approach to SARS-CoV-2-associated MIS-C

All hands on deck: A multidisciplinary approach to SARS-CoV-2-associated MIS-C

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

SARS-CoV-2 infection in technology-dependent children: a multicenter case series

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