ABSTRACT
Aim: Aim of this study is evaluate the clinical features, laboratory values, treatment and follow-up of in children with COVID-19-associated multisystem inflammatory syndrome (MIS-C) disease. Materials and Methods: In this study, patients aged between 2 months and 17 years, who applied to the Inonu University Faculty of Medicine, Department of Pediatrics between March 2020, and February 2021 due to MIS-C related to COVID-19 disease, were reviewed retrospectively. Demographic data, clinical features, laboratory values, treatment and follow-up data of the patients were evaluated. Results: Forty-nine patients diagnosed with MIS-C between March 2020 and February 2021 were included in the study. Thirty-one (72.7%) patients were male and 18 (27.3%) were female. The most common indications for admission were fever (100%), abdominal pain (51.6%), vomiting (42.9%), cough (38.8%), diarrhea (28.8%), shortness of breath, rash, conjunctivitis, and convulsion. Levels of CRP (93.9%), D-dimer (85.7%), fibrinogen (73.4%), interleukin 6 (IL6) (73.4%), procalcitonin (71.4%), NT-proBNP (63.2%) remained at high levels in respective number of patients. The (32.6%) patients were followed up in the intensive care unit. These patients had cardiogenic shock (26.5%), severe pneumonia (18.3%), and acute gastroenteritis (14.3%). It was determined that the mean age of the patients followed up for cardiogenic shock was 12.5 years and relatively higher (p < 0.05). One patient died during follow-up. Conclusion: Although the manifestations of MIS- C due to COVID -19 are seen relatively rarely in children, it constitutes a serious problem and they mostly require hospitalization in intensive care unit, simultaneously involves many organ systems, and leads a serious course with higher risk of mortality. Another problem in these patients is higher rates of cardiac involvement. For this reason, it is important to take necessary precautions to protect children against COVID 19 and its associated MIS-C, and to include them in vaccination programs.
ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) has been infecting children since December 2019 and has caused a severe epi-demic and millions of deaths worldwide. COVID-19 has severe clinical effects and is more complicated to manage in patients with underlying diseases, such as congenital heart disease (CHD), past surgical operations, arrhythmia, and end-organ damage. Objectives: This study aimed to evaluate the clinical course, follow-up, and treatment process of patients with CHD and COVID-19 in Inonu University Faculty of Medicine, Department of Pediatrics, Turkey during March 2020-February 2021. Methods: This retrospective study was performed on patients with CHD and COVID-19 in the Department of Pediatrics at Inonu University Faculty of Medicine during March 2020-February 2021, selected by making full count sampling. Admission complaints, clinical findings, biochemical parameters, echocardiography results, hospitalization times, treatments, and clinical follow-up findings were retrieved from patients’ files. Results: 11 patients with underlying CHD and COVID-19 were evaluated retrospectively during the study. Ten patients were hospitalized and treated due to COVID-19. Treatment of seven of these patients continued in the intensive care unit (ICU), and five were followed up under a mechanical ventilator. Two patients died during follow-up in the ICU. Conclusions: The clinical course of COVID-19 is severe, and the mortality rate is high in patients with serious diseases, such as underlying CHD. Therefore, COVID-19 in patients with CHD requires more serious and careful follow-up.