Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 18:11:1167871.
doi: 10.3389/fped.2023.1167871. eCollection 2023.

Characteristics and outcomes of multisystem inflammatory syndrome in children: A multicenter, retrospective, observational cohort study in Mexico

Marco Antonio Yamazaki-Nakashimada  1 , Horacio Márquez-González  2 , Guadalupe Miranda-Novales  3 , Gonzalo Antonio Neme Díaz  4 , Sandhi Anel Prado Duran  5 , Antonio Luévanos Velázquez  6 , Maria F Castilla-Peon  7 , Nadia González-García  2 , Miguel Alejandro Sánchez Duran  1 , Martha Patricia Márquez Aguirre  1 , Miguel Angel Villasis-Keever  3 , Ranferi Aragón Nogales  3 , Juan Carlos Núñez-Enríquez  3 , Maria Elena Martinez Bustamante  8 , Carlos Aguilar Argüello  4 , Jesús Ramírez de Los Santos  4 , Alejandra Pérez Barrera  4 , Lourdes Anais Palacios Cantú  5 , Jesús Membrila Mondragón  5 , Paloma Vizcarra Alvarado  6 , Rodolfo Norberto Jiménez Juárez  2 , Víctor Olivar López  2 , Roberto Velasco-Segura  9 , Adrián López Chávez  2
Affiliations

Characteristics and outcomes of multisystem inflammatory syndrome in children: A multicenter, retrospective, observational cohort study in Mexico

Marco Antonio Yamazaki-Nakashimada et al. Front Pediatr. .

Abstract

Introduction: Multisystem inflammatory syndrome in children associated with coronavirus disease 2019 (MIS-C), a novel hyperinflammatory condition secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with severe outcomes such as coronary artery aneurysm and death.

Methods: This multicenter, retrospective, observational cohort study including eight centers in Mexico, aimed to describe the clinical characteristics and outcomes of patients with MIS-C. Patient data were evaluated using latent class analysis (LCA) to categorize patients into three phenotypes: toxic shock syndrome-like (TSSL)-MIS-C, Kawasaki disease-like (KDL)-MIS-C, and nonspecific MIS-C (NS-MIS-C). Risk factors for adverse outcomes were estimated using multilevel mixed-effects logistic regression.

Results: The study included 239 patients with MIS-C, including 61 (26%), 70 (29%), and 108 (45%) patients in the TSSL-MIS-C, KDL-MIS-C, and NS-MIS-C groups, respectively. Fifty-four percent of the patients were admitted to the intensive care unit, and 42%, 78%, and 41% received intravenous immunoglobulin, systemic glucocorticoids, and anticoagulants, respectively. Coronary artery dilatation and aneurysms were found in 5.7% and 13.2% of the patients in whom coronary artery diameter was measured, respectively. Any cause in-hospital mortality was 5.4%. Hospitalization after ten days of symptoms was associated with coronary artery abnormalities (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2-2.0). Age ≥10 years (OR: 5.6, 95% CI: 1.4-2.04), severe underlying condition (OR: 9.3, 95% CI: 2.8-31.0), platelet count <150,000 /mm3 (OR: 4.2, 95% CI: 1.2-14.7), international normalized ratio >1.2 (OR: 3.8, 95% CI: 1.05-13.9), and serum ferritin concentration >1,500 mg/dl at admission (OR: 52, 95% CI: 5.9-463) were risk factors for death.

Discussion: Mortality in patients with MIS-C was higher than reported in other series, probably because of a high rate of cases with serious underlying diseases.

Keywords: Mexico; coronary aneurism; coronavirus disease (COVID)-19; multicenter study; multisystem inflammatory syndrome; pediatric; severe acute respiratory syndrome coronavirus (SARS-CoV).

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Licciardi F, Pruccoli G, Denina M, Parodi E, Taglietto M. SARS-CoV-2 – induced kawasaki-like hyperin flammatory syndrome : a novel COVID phenotype in children. Pediatrics. (2021) 146(2):1–5. 10.1542/peds.2020-1711 - DOI - PubMed
    1. https://emergency.cdc.gov/han/2020/han00432.asp Centers for Disease Control and Prevention. HAN Archive - 00432 | Health Alert Network (HAN). Available at: (Cited December 13, 2021).
    1. Royal College of Paediatrics and Child Health. Guidance paediatric multisystem inflammatory syndrome temporallly associated with Cov-19. Royal College of Paediatrics and Child Health. (2020). p. 1–6. Available at: https://www.rcpch.ac.uk/resources/paediatric-multisystem-inflammatory-sy...
    1. Jiang L, Tang K, Levin M, Irfan O, Morris SK, Wilson K, et al. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. (2020) 20(11):e276–88. 10.1016/S1473-3099(20)30651-4 - DOI - PMC - PubMed
    1. Walensky RP, Bunnell R, Layden J, Kent CK, Gottardy AJ, Leahy MA, et al. Morbidity and mortality weekly report council of state and territorial epidemiologists/CDC surveillance case definition for multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection-United States centers for disease control and prevention MMWR editorial and production staff (Serials) MMWR editorial board CONTENTS. Vol. 71, Recommendations and Reports (2022). - PMC - PubMed

LinkOut - more resources