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. 2023 Feb 12;11(4):544.
doi: 10.3390/healthcare11040544.

Clinical Characteristics and Laboratory Findings in Children with Multisystem Inflammatory Syndrome (MIS-C)-A Retrospective Study of a Tertiary Care Center from Constanta, Romania

Cristina Maria Mihai  1   2 , Tatiana Chisnoiu  1   2 , Adriana Luminita Balasa  1   2 , Corina Elena Frecus  1   2 , Larisia Mihai  1   2 , Alexandru Cosmin Pantazi  1   2 , Alina Zorina Stuparu  3   4 , Any Axelerad  3   4
Affiliations

Clinical Characteristics and Laboratory Findings in Children with Multisystem Inflammatory Syndrome (MIS-C)-A Retrospective Study of a Tertiary Care Center from Constanta, Romania

Cristina Maria Mihai et al. Healthcare (Basel). .

Abstract

A new hyper-inflammatory syndrome in children was identified after SARS-CoV-2 infection as a post-infectious complication that is temporally associated with coronavirus disease (COVID-19). Fever, rash, conjunctival hyperemia, and gastrointestinal problems are all clinical manifestations of multisystem inflammatory syndrome in children. This condition, in some cases, causes multisystem involvement, affecting multiple organ systems and necessitating admission to a pediatric intensive care unit. Due to limited clinical studies, it is necessary to analyze the characteristics of the pathology in order to improve the management and long-term follow-up of high-risk patients. The objective of the study was to analyze the clinical and paraclinical characteristics of children diagnosed with MIS-C. The clinical study is a retrospective, observational, descriptive research work that includes patients diagnosed with MIS-C, temporally associated with coronavirus disease, and it contains clinical characteristics, laboratory data, and demographic information. The majority of patients had normal or slightly increased leukocyte counts, which were associated with neutrophilia, lymphocytopenia, and significantly elevated inflammatory markers, including high levels of C-reactive protein, fibrinogen, the erythrocyte sedimentation rate, serum ferritin, and IL 6 and elevated levels of the cardiac enzymes NT-proBNP and D-dimers, owing to the cardiovascular system involvement in the pro-inflammatory process. At the same time, renal system involvement led to raised creatinine and high proteinuria in association with hypoalbuminemia. This characteristic of the pro-inflammatory status as well as multisystem impairment are highly suggestive of the post-infection immunological reaction of the multisystem syndrome temporally associated with SARS-CoV-2 infection.

Keywords: COVID-19 infection; hyperinflammation; multisystem inflammatory syndrome.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A). The trendline of the values of leukocytes. (B). The trendline of the values of neutrophils. (C). The trendline of the values of lymphocytes. (D). The trendline of the values of platelets. (E). The trendline of the values of C-reactive protein.
Figure 1
Figure 1
(A). The trendline of the values of leukocytes. (B). The trendline of the values of neutrophils. (C). The trendline of the values of lymphocytes. (D). The trendline of the values of platelets. (E). The trendline of the values of C-reactive protein.
Figure 2
Figure 2
(A). The trendline of the values of the erythrocyte sedimentation rate. (B). The trendline of the values of serum ferritin. (C). The trendline of the values of GOT. (D). The trendline of the values of GPT.
Figure 2
Figure 2
(A). The trendline of the values of the erythrocyte sedimentation rate. (B). The trendline of the values of serum ferritin. (C). The trendline of the values of GOT. (D). The trendline of the values of GPT.
Figure 3
Figure 3
(A). The trendline of the values of fibrinogen. (B). The trendline of the values of D-dimers. (C). The trendline of the values of NT-proBNP.
Figure 3
Figure 3
(A). The trendline of the values of fibrinogen. (B). The trendline of the values of D-dimers. (C). The trendline of the values of NT-proBNP.
Figure 4
Figure 4
The image presented an illustration of the processes and mechanisms associated with “cytokine storm,” as well as the findings of laboratory experiments.
See this image and copyright information in PMC

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