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

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.

Consenso sobre la infección por COVID-19 (SARS-COV-2)

On January 15, 2020, the World Health Organization (WHO) made the first recommendations regarding the epidemiological surveillance of a new coronavirus detected on December 31, 2019 in the Hubei province of Wuhan city, China --which later (January 7, 2020) was identified as a new coronavirus, or an emerging corona-virus, initially called "2019-nCoV"-- and issued the first case definitions, when was detected 27 cases of acute respiratory syndrome of unknown etiology. This virus would eventually be called "COVID-19" or "SARS-CoV-2". It's spread around the world did not take long, and despite the fact that the WHO delayed declaring this outbreak as a pandemic event, it finally did so on March 11 of the current year. The Mexican Academy of Pediatrics (advisory body of the Secretary of Health) considered made up prudent to compile the facts to issue, as soon as possible, an expanded overview of infection-disease by this emerging virus and, at the same time, as its main objective is to contribute, support and work together with the Secretary of Health to combat the SARS-CoV-2 epidemic in order to provide the best care and treatment measures to mitigate its spread throughout the Mexican territory. (English) [ABSTRACT FROM AUTHOR] El 15 de enero de 2020, la Organización Mundial de la Salud (OMS) realizó las primeras recomendaciones respecto a la vigilancia epidemiológica de un nuevo co-ronavirus, detectado el 31 de diciembre de 2019 en la provincia de Hubei, ciudad de Wuhan, en China --que, posteriormente (07 de enero de 2020) fue identificado como un nuevo coronavirus, o bien, un coronavirus emergente, inicialmente denominado "2019-nCoV"--, y emitió las primeras definiciones de caso, tras haberse detectado en 27 sujetos con síndrome respiratorio agudo de etiología desconocida. Dicho virus, a la postre, se denominaría "COVID-19" o "SARS-CoV-2". Su diseminación en todo el mundo no tardó mucho, y a pesar de que la OMS retrasó la declaración del brote como un evento pandémico, finalmente lo hizo el 11 de marzo del año en curso. La Academia Mexicana de Pediatría (órgano asesor de la Secretaría de Salud) consideró prudente hacer una recopilación de los hechos para emitir, en lo posible, un panorama ampliado de la infección-enfermedad por este virus emergente y, a la vez, se planteó como principal objetivo contribuir, apoyar y trabajar en conjunto con la Secretaría de Salud para enfrentar la epidemia asociada con el SARS-CoV-2 para que se implementen las mejores medidas de atención y tratamiento a fin de mitigar su diseminación en el territorio mexicano. (Spanish) [ABSTRACT FROM AUTHOR] Copyright of Revista de Enfermedades Infecciosas en Pediatria is the property of Ediciones Franco S.A. de C.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)