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Multisystem inflammatory syndrome associated with covid-19 in children: The spectrum of clinical presentation, myocardial involvement and treatment outcome
Pakistan Paediatric Journal ; 44(4 SUPPL):5-6, 2020.
Article in English | EMBASE | ID: covidwho-1106877
ABSTRACT

Objective:

To determine the spectrum of clinical presentation, multisystem involvement and treatment outcome in children with MIS-C. Study

Design:

A descriptive cohort study Place and Duration of Study Conducted at The Children's Hospital and Institute of Child Health, Lahore from May 15, 2020 to November 22, 2020. Material and

Methods:

Children (aged 0-16 years) with features of this new inflammatory syndrome who fulfilled the WHO criteria for MIS-C and required admission to hospital were prospectively identified. Demographic and clinical data were collected from patient records and entered on a predesigned proforma and results were analyzed on SPSS 20.

Results:

A total of 24 patients were enrolled in the study. Majority were males (17/24, 70%). Mean age of presentation was 7.3 years. Six patients (25%) had a positive PCR for SARS CoV-2 but none of the patients had been symptomatic with classic COVID-19 respiratory symptoms in the 6 weeks prior to admission. Comorbid conditions were present in only 2 patients (8%). SARS-CoV-2 antibodies were positive for 23/24 patients (96%). Despite being clinically unwell, with laboratory evidence of elevated C-reactive protein, ferritin, and D-dimers, no pathological organism was isolated in any of the 24 children. There were two major presentations one as atypical or typical Kawasaki disease (18 of 24, 75%) and a more severe second one with shock or low cardiac output (6 of 24, 25%). Common presenting features were fever, body aches, and abdominal pain. Four out of 24 (16%) patients had sufficient criteria for typical Kawasaki disease, whereas 18 children (75%) presented more sub acutely with presentation resembling Kawasaki disease;all had at least two features of classic Kawasaki. Myocardial dysfunction seen in 3 patients (12%) and pericardial effusion was observed in 5 patients (20%). Coronary artery dilatation was seen in 12 (50%) patients. All 6 children with shock-like presentation had coronary artery involvement. Twenty children (83%) received intravenous immunoglobulin within the first 2 days of their stay. Thirteen (54%) patients received therapeutic anticoagulation (enoxaparin) on the basis of the high risk of thromboembolism and number of D-dimers. There was one death (4%).

Conclusion:

The SARS-COV 19 pandemic led to the identification of a new and potentially life-threating childhood disease, referred to as MIS-C. Prompt diagnosis and early treatment with IVIGs has shown a good early outcome. .
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Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: Pakistan Paediatric Journal Year: 2020 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: Pakistan Paediatric Journal Year: 2020 Document Type: Article