Twelve Months of MIS-C: Does Increasing Experience Improve Resource Utilization?

Abstract

Objective: Define the clinical characteristics, outcomes, and resource utilization patterns in pediatric patients with Multisystem Inflammatory Syndrome in Children (MIS-C) hospitalized at our center over the first year of the pandemic. Methods:Retrospective case series of patients < 22 years with a discharge diagnosis of MIS-C between 5/1/20 and 4/30/21.Demographic, clinical, and outcome data was collected and analyzed. We then performed an analysis comparing resource utilization in the first six months of the time period to the second six months in the time period. Results: Forty eight percent (38/81) of our population had a greater than 2g/dl drop in their hemoglobin during their hospitalization. 73% (59/81) had a 1g/dl or greater drop. Of the recommended labs, CRP (100%), D-dimer (98%), Ferritin (91%), ESR (87%) Procalcitonin (85%), Fibrinogen (85%) and BNP (85%) were most frequently abnormal. Triglycerides (17%), PT/PTT (50%) and LDH (59%) were least frequently abnormal. Between the two defined time periods, there was no statistically significant improvement in the number of lab draws obtained aside from lab draws for triglycerides (p = .049). Conclusions:Our clinical findings are consistent with those already published in the literature. Outcomes were also positive, with no deaths in our cohort and 83% had no cardiac abnormalities six weeks after admission. Laboratory resource utilization was substantial and did not improve over the first year of MIS-C cases at our organization. Our patients with MIS-C did frequently experience significant drops in their hemoglobin. There is likely opportunity to refine the available guidelines for the management of MIS-C.