Anti-severe complication of severe acute respiratory syndrome coronavirus 2 antibodies, Coronavirus disease 2019, Intravenous immunoglobulin, Multisystem inflammatory syndrome in children, Myocardial dysfunction, Kawasaki disease
Citation Information :
Bhattad S, Sadashiva R, Mohite RS, Arigela K, Naushad SM, Unni J, Pillai R, Cyril G, Paul G, Kumar S, Kumar S, Anand M, Anirudhan V, Thyagarajan S, Budur S, Malvel S, Raghuram J, Murthy S, Kumar L, Ginigeri C. Profile of Multisystem Inflammatory Syndrome in Children Related to COVID-19: A Multicentric Study from South India. Pediatr Inf Dis 2023; 5 (2):37-41.
Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection associated with significant morbidity and can be fatal if left unrecognized.
A retrospective multicentric study was carried out at five tertiary care centers in South India, to evaluate the clinical profile of children admitted with MIS-C associated with SARS-CoV-2 infection. Cases of MIS-C diagnosed during October 2020 to December 2021 were included. Diagnosis of MIS-C was based on World Health Organization (WHO) criteria. All children underwent echocardiography at admission, discharge, and 4–6 weeks of follow-up. Children with MIS-C were treated with intravenous immunoglobulin (IVIG) and/or steroids. We compared younger children (<5 years of age) with older ones to determine if age at presentation could predict severity in children with MIS-C. A total of 81 children were diagnosed to have MIS-C during the study period. The mean age of presentation was 6.8 years. Around 29.6% of the children had a shock at admission and 54.3% had myocardial dysfunction. The average duration of a pediatric intensive care unit (PICU) stay was 6.6 days. Anti-SARS-CoV-2 antibodies were found to be positive in 75.3% of patients. Children with high N-terminal prohormone of brain natriuretic peptide (NT-proBNP) had more severe presentations. All children responded promptly to IVIG and steroids and the mortality was 0%. No difference was noted in terms of outcome between younger (<5 years) and older children. A significant proportion of children with MIS-C present with shock and myocardial dysfunction. Anti-SARS-CoV-2 antibodies were positive in 75% of children whose primary infection went unnoticed. We hereby report one of the largest cohorts of MIS-C patients from the Indian subcontinent.
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