ABSTRACT
MIS-C diagnosis was made according to US Centers for Disease Control and Prevention (CDC) criteria. Patients'demographic and clinical features, laboratory parameters, bradycardia related characteristics (timing and duration of bradycardia, resolving time of bradycardia, association between the bradycardia and the treatments utilized, heart rate, and electrocardiographic (ECG) findings) were recorded. MIS-C diagnosis was made according to US Centers for Disease Control and Prevention (CDC) criteria when all these 4 criteria were present: 1. Clinical presentation consistent with MIS-C, including all of the following: a. Fever >38.0°C for >24 hours b. Laboratory evidence of inflammation (Including but not limited to one or more of the following: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, D-dimer, ferritin, lactic acid dehydrogenase (LDH), interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes and low albumin) c. Multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological) d. Evidence of clinically severe illness requiring hos pitalization 3.
ABSTRACT
The pathophysiology of multisystem inflammatory syndrome (MIS) in children (MIS-C) is unknown. It occurs several weeks after COVID-19 infection or exposure; however, MIS is rarely reported after COVID-19 vaccination, and cases are mostly in adults. Herein, we present a 12-year-old male who had no prior COVID-19 infection or exposure and developed MIS-C after his first dose of COVID-19 mRNA vaccine.
Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/complications , Systemic Inflammatory Response Syndrome/etiology , Vaccines, Synthetic/adverse effects , mRNA Vaccines/adverse effects , COVID-19/diagnosis , COVID-19/etiology , COVID-19/prevention & control , Child , Diagnosis, Differential , Drug Therapy, Combination , Glucocorticoids/therapeutic use , Humans , Immunoglobulins, Intravenous/therapeutic use , Male , Methylprednisolone/therapeutic use , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/drug therapy , COVID-19 Drug TreatmentABSTRACT
BACKGROUND: The aim of this study was to evaluate the epidemiological, demographic, clinical characteristics and laboratory findings of pediatric COVID-19 patients. METHODS: Patients with a positive COVID-19 nasopharyngeal polymerase chain reaction (PCR) test between 11 March 2020 and 31 December 2020 were evaluated. RESULTS: During the study period, 3118 patients underwent PCR tests, and 621 of them (19.9%) were positive. Of the patients with a positive test result, 335 were male (53.9%), the median age was 11 years. There were 308 (49.6%) patients that had a history of household exposure. The mean time between the onset of the patients complaints and the diagnosis was 1.88 ± 1.16 days. The most common symptoms were: fever (n = 424), cough (n = 419) and nasal symptoms (n = 157); loss of smell (3.5%) and taste (4.3%) were other symptoms observed in only patients aged 10 years or older. The most common abnormal laboratory finding was lymphopenia (n = 29, 36.7%). Of the 621 patients, the vast majority (n = 546, 87.9%) were classified as mild COVID-19 disease. There was a significant relationship between disease severity and age and comorbidity (p = 0.01 and p < 0.001, respectively). Only 34 patients (5.5%) were admitted to hospital, and two patients were followed-up with a diagnosis of multisystem inflammatory syndrome in children. The mortality rate was 0.32%. CONCLUSION: COVID-19 can cause different symptoms in children. Although the disease generally causes a mild clinic presentation, it should be kept in mind that it may be more severe especially in children with comorbidities.
Subject(s)
COVID-19 , Child , Demography , Emergency Service, Hospital , Humans , Laboratories , Male , SARS-CoV-2 , Systemic Inflammatory Response SyndromeABSTRACT
AIM: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection may result in a life-threatening hyperinflammatory condition named multisystem inflammatory syndrome in children (MIS-C). We aimed to assess demographics, clinical presentations, laboratory characteristics and treatment outcomes of patients with MIS-C. METHODS: We performed a retrospective study of patients with MIS-C managed between August 2020 and March 2021 at Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital in Turkey. RESULTS: A total of 45 patients (23 male, 51%) with a median age of 8.7 years (interquartile range: 5.6-11.7 years) were enrolled to study. The SARS-CoV-2 serology was positive in 43 (95%) patients. Organ-system involvement included the dermatologic in 41 (91%), cardiovascular in 39 (87%), hematologic in 36 (80%) and gastrointestinal in 36 (80%) patients. Acute anterior uveitis was diagnosed in nine (20%) patients. Two patients presented with clinical findings of deep neck infection such as fever, neck pain, trismus, swelling and induration on the cervical lymph node. One patient presented with Henoch-Schonlein purpura-like eruption. Coronary artery dilatation was detected in five (11%) patients. For treatment of MIS-C, intravenous immunoglobulin was used in 44 (98%) patients, methylprednisolone in 27 (60%) and anakinra in 9 (20%) patients. The median duration of hospitalisation was nine days. All patients recovered. CONCLUSIONS: Children with MIS-C might have variable clinical presentations. Acute anterior uveitis might be a prominent presentation of MIS-C and require ophthalmological examination. It is essential to make patient-based decisions and apply a stepwise approach for the treatment of this life-threatening disease.