Multisystem Inflammatory Syndrome in Children (MIS-C) Associated With COVID-19–Single-Center Experience

Indian Pediatrics - Tập 60 - Trang 389-393 - 2023
Poovazhagi Varadarajan1, S. Elilarasi2, Ritchie Sharon Solomon3, Seenivasan Subramani1, Ramesh Subramanian1, Nisha Rangabashyam1, Gomathy Srividya1
1Department of Pediatric Intensive Care, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India
2Department of Pediatric Pulmonology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India
3Department of Pediatric Cardiology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India

Tóm tắt

To describe the clinical presentation, phenotype and outcome of multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) from a tertiary care center in southern India. 257 children fulfilling the inclusion criteria of MIS-C were prospectively enrolled from June, 2020 to March, 2022. Median (range) age at presentation was 6 year (35 day to 12 years). Presenting features were fever (98%), vomiting (75.8%), red eyes (63%), rashes (49%), pain abdomen (49%), shock (45.9%), lymphopenia (73%, thrombocytopenia (58.3%) and anemia (45%). 103 (39.7%) children required intensive care admission. Shock phenotype, Kawasaki-like phenotype and no specific phenotype were diagnosed in 45.9%, 44.4%, and 36.6% children, respectively. Left ventricular dysfunction (30.3%), acute kidney injury (13%), acute liver failure (17.4%), and hemophagolymphohistiocytosis (HLH) (13.6%) were the major system involvement in MIS-C. Mitral regurgitation (P=0.029), hyperechogenic coronaries (P=0.006), left ventricular dysfunction (P=0.001) and low ejection fraction (P=0.007) were significantly associated with shock. Overall mortality was 11.7%. Kawasaki-like and shock-like presentation were common in MIS-C. Coronary abnormalities were seen in 118 (45.9%) children. Children with acute kidney injury, HLH, need for mechanical ventilation, and echocardiogram evidence of mitral regurgitation in MIS-C have a poor outcome.

Tài liệu tham khảo

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