ABSTRACT
BACKGROUND AND AIM: Multisystem inflammatory syndrome in children (MIS-C) has been associated with SARS-CoV-2 infection in pediatric population treated at Pediatric Intensive Care Unit (PICU). To compare patients with pediatric acute respiratory distress syndrome (PARDS) with those who also presented a diagnosis of MIS-C. METHOD(S): Retrospective cohort study with 167 patients admitted to the PICU Covid-19 at Baca Ortiz Pediatric Hospital (BOPH) located in Quito, Ecuador from June 2020 - June 2021, who developed PARDS with or without MIS-C. We performed a logistic regression analysis to calculated Odds Ratios (OR) with 95% CI. RESULT(S): Of the 167 patients, PCR test was positive in 20.1%. 58.7% of the study population developed MIS-C. This was associated with respiratory bacterial coinfection (OR: 3.63 [95% CI: 1.81-7.29]), circulatory support (OR: 38.8 [11.2-134.6]), acute renal failure (OR: 6.09 [2.4-15.5]), septic shock (OR: 89.9 [28.5-283.9]), coronary dilatation (OR: 3.79 [1.45-9.8]);multi-organ failure (OR: 44.9 [5.99- 337.3]), death (OR: 14.5 [4.27-49.5]). Further, a severe inflammatory state and high risk of sepsis were present as shown by an elevated D-dimer (OR: 6.53 [2.06-20.7]);total CPK (6.96 [3.5-13.9]);and procalcitonin (OR: 10.5 [5.06- 21.8]). Treatment in the MIS-C group included antibiotics (100%), corticoids (79.5%), immunoglobulin (IV) (86.4%), and ventilatory support (11.5 +/- 12.6 days). CONCLUSION(S): The MIS-C associated with Covid-19 produced a more severe condition, as a result of a dysregulated inflammatory state;which resulted in failure of various organ systems and high mortality in the PICU. This was evidenced by the clinical and analytical profile and the treatments used.