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Observational Study
. 2023 Jan;65(1):e15431.
doi: 10.1111/ped.15431.

Multicentre observational study on multisystem inflammatory syndrome related to COVID-19 in Argentina

Eduardo Vainstein  1 , Silvia Baleani  1 , Luis Urrutia  2 , Nicolás Affranchino  2 , Judith Ackerman  3 , Mariana Cazalas  4 , Alejandro Goldsman  4 , Angela Sardella  5 , Ana Laura Tolin  6 , Pablo Goldaracena  7 , Mariana Fabi  8 , Mariana Cosentino  9 , Ricardo Magliola  10 , Gustavo Roggiero  11 , Paula Manso  12 , Jésica Triguy  6 , Celeste Ballester  6 , Vanesa Cervetto  13 , María Vaccarello  14 , Domingo Norberto De Carli  15 , Maria Estela De Carli  15 , Ana Laura Ciotti  16 , María Irene Sicurello  5 , Cecilia Rios Leiva  17 , Claudia Villalba  18 , María Hortas  19 , Sonia Peña  6 , Gabriela González  20 , Camila Lidia Zold  21 , Mario Gustavo Murer  21 ; EMSKC Group
Collaborators, Affiliations
Observational Study

Multicentre observational study on multisystem inflammatory syndrome related to COVID-19 in Argentina

Eduardo Vainstein et al. Pediatr Int. 2023 Jan.

Abstract

Background: The impact of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in low- and middle-income countries remains poorly understood. Our aim was to understand the characteristics and outcomes of PIMS-TS in Argentina.

Methods: This observational, prospective, and retrospective multicenter study enrolled patients younger than 18 years-old manifesting PIMS-TS, Kawasaki disease (KD) or Kawasaki shock syndrome (KSS) between March 2020 and May 2021. Patients were followed-up until hospital discharge or death (one case). The primary outcome was pediatric intensive care unit (PICU) admission. Multiple logistic regression was used to identify variables predicting PICU admission.

Results: Eighty-one percent, 82%, and 14% of the 176 enrolled patients fulfilled the suspect case criteria for PIMS-TS, KD, and KSS, respectively. Temporal association with SARS-CoV-2 was confirmed in 85% of the patients and 38% were admitted to the PICU. The more common clinical manifestations were fever, abdominal pain, rash, and conjunctival injection. Lymphopenia was more common among PICU-admitted patients (87% vs. 51%, p < 0.0001), who also showed a lower platelet count and higher plasmatic levels of inflammatory and cardiac markers. Mitral valve insufficiency, left ventricular wall motion alterations, pericardial effusion, and coronary artery alterations were observed in 30%, 30%, 19.8%, and 18.6% of the patients, respectively. Days to initiation of treatment, rash, lymphopenia, and low platelet count were significant independent contributions to PICU admission.

Conclusion: Rates of severe outcomes of PIMS-TS in the present study agreed with those observed in high-income countries. Together with other published studies, this work helps clinicians to better understand this novel clinical entity.

Keywords: COVID-19; Kawasaki disease; Kawasaki shock syndrome; multisystem inflammatory syndrome in children; pediatric multisystem inflammatory syndrome.

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References

REFERENCES

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