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Observational Study
. 2022 Nov;58(11):1964-1971.
doi: 10.1111/jpc.16129. Epub 2022 Jul 23.

Clinical profile and outcomes of multisystem inflammatory syndrome in children (MIS-C): Hospital-based prospective observational study from a tertiary care hospital in South India

Pediredla Karunakar  1 , Jaikumar G Ramamoorthy  1 , Avinash Anantharaj  2 , Narayanan Parameswaran  1 , Niranjan Biswal  1 , Rahul Dhodapkar  3 , Maanasa Bhaskar  3 , Debdatta Basu  4 , Sindhusuta Das  3 , Anitha Gunalan  3
Affiliations
Observational Study

Clinical profile and outcomes of multisystem inflammatory syndrome in children (MIS-C): Hospital-based prospective observational study from a tertiary care hospital in South India

Pediredla Karunakar et al. J Paediatr Child Health. 2022 Nov.

Abstract

Aim: To study the clinical profile and outcomes in children with multisystem inflammatory syndrome in children (MIS-C).

Methods: Children aged 1 month to 15 years presenting with MIS-C (May 2020 to November 2021) were enrolled. Clinical, laboratory, echocardiography parameters and outcomes were analysed.

Results: Eighty-one children (median age 60 months (24-100)) were enrolled. Median duration of fever was 5 days (3-7). Twenty-nine (35.8%) had shock (severe MIS-C) including 23 (28.3%) requiring inotropes (median duration = 25 h (7.5-33)). Ten required mechanical ventilation, 12 had acute kidney injury and 1 child died. Left ventricular (LV) dysfunction was seen in 38 (46.9%), 16 (19.7%) had coronary artery abnormalities (CAA) and 13 (20%) had macrophage activation syndrome. Sixty-one (75.3%) were SARS CoV-2 positive (10 by RT-PCR and 51 by serology). Sixty-eight (83.9%) received immunomodulators. Younger age was significantly associated with CAA (P value = 0.05). Older age, LV dysfunction, SARS CoV-2 positivity, low platelet count and elevated serum ferritin were significantly associated with severe MIS-C (univariate analysis). Younger age was an independent predictor of CAA (P = 0.05); older age (P = 0.043) and low platelet count (P = 0.032) were independent predictors of severe MIS-C (multivariate logistic regression analysis).

Conclusion: Our patients had diverse clinical manifestations with a good outcome. Younger age was significantly associated with CAA. Older age, LV dysfunction, low platelet count and elevated serum ferritin were significantly associated with severe MIS-C. Younger age is an independent predictor of CAA. Older age and low platelet count are independent predictors of severe MIS-C.

Keywords: Kawasaki disease; MIS-C; SARS CoV-2; coronary artery abnormalities; left ventricular systolic dysfunction; macrophage activation syndrome.

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References

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