Neurological Manifestations of COVID-19 Associated Multisystem Inflammatory Syndrome in Children (MIS-C) in Yogyakarta, Indonesia

ABSTRACT

Objective: This observational cohort study aims to provide data on pediatric patients with neurological manifestations associated with multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease (COVID-19). Methods: Patients aged <18 with neurologic symptoms and severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection from January, 2021 to January, 2022 at the Dr. Sardjito Hospital in Yogyakarta, Indonesia were evaluated. We used WHO diagnostic criteria to classify patients as MIS-C or non-MIS-C. Demographic information, symptoms, and outcomes were compared between MIS-C and non-MIS-C groups. Results: Between January, 2021 and January, 2022, 74 pediatric patients were considered eligible. More than half of the patients were female (54.1%), and 24.3% presented with MIS-C. Length of hospitalization was significantly longer in MIS-C individuals (P=0.006). The commonest neurological findings were involuntary movements (43.2%) and paresis (27%). The commonest neuroimaging findings were meningoencephalitis (18.9%) and hydrocephalus (22.9%). Among all the variety of neurologic manifestations in non-MIS-C and MIS-C patients, a statistically significant result was found for fever (71.4% vs 100%; P=0.015), altered mental state (14.2% vs 50%, P=0.004), and paresis (33.9% vs 5.5%, P=0.030). Conclusion: MIS-C was found in 24% of our patients with acute neurologic symptoms, and most cases (51.8%) had positive SARS-CoV-2 antibody results.