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Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis.
Mohsin, Shazia S; Abbas, Qalab; Chowdhary, Devyani; Khalid, Farah; Sheikh, Abdul Sattar; Ali Khan, Zuviya Ghazala; Aslam, Nadeem; Bhatti, Omaima Anis; Inam, Maha; Saleem, Ali Faisal; Bhutta, Adnan T.
  • Mohsin SS; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
  • Abbas Q; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
  • Chowdhary D; Cardiology Care for Children and Children's Hospital of Philadelphia, Philadelphia, PA, United States of America.
  • Khalid F; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
  • Sheikh AS; National Institute of Cardiovascular Diseases, Karachi, Pakistan.
  • Ali Khan ZG; Aga Khan University Medical College, Karachi, Pakistan.
  • Aslam N; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
  • Bhatti OA; Aga Khan University Medical College, Karachi, Pakistan.
  • Inam M; Aga Khan University Medical College, Karachi, Pakistan.
  • Saleem AF; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
  • Bhutta AT; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States of America.
PLoS One ; 16(6): e0253625, 2021.
Article in English | MEDLINE | ID: covidwho-1280637
ABSTRACT

OBJECTIVES:

To determine clinical, laboratory features and outcomes of Multisystem Inflammatory Syndrome in children (MIS-C) and its comparison with historic Kawasaki Disease (KD) and Viral Myocarditis (VM) cohorts.

METHODS:

All children (1 month- 18 years) who fulfilled the World Health Organization criteria of MIS-C presenting to two tertiary care centers in Karachi from May 2020 till August 31st were included. KD and VM admitted to one of the study centers in the last five years prior to this pandemic, was compared to MIS-C.

RESULTS:

Thirty children with median age of 24 (interquartile range (IQR)1-192) months met the criteria for MIS-C. Three phenotypes were identified, 12 patients (40%) with KD, ten (33%) VM and eight (26%) had features of TSS. Echocardiography showed coronary involvement in 10 (33%), and moderate to severe Left Ventricular dysfunction in 10 (33%) patients. Steroids and intravenous immunoglobulins (IVIG) were administered to 24 (80%) and 12 (41%) patients respectively while 7 (23%) received both. Overall, 20% children expired. During the last five years, 30 and 47 children were diagnosed with KD and VM, respectively. Their comparison with MIS-C group showed lymphopenia, thrombocytosis, and higher CRP as well as more frequent atypical presentation in MIS-C KD group with less coronary involvement. The MIS-C VM was more likely to present with fulminant myocarditis.

CONCLUSIONS:

Our MIS-C cohort is younger with higher mortality compared to previous reports. MIS-C is distinct from historic cohorts of KD and VM in both in clinical features and outcomes.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / COVID-19 / Mucocutaneous Lymph Node Syndrome / Myocarditis Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0253625

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / COVID-19 / Mucocutaneous Lymph Node Syndrome / Myocarditis Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Infant, Newborn Country/Region as subject: Asia Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0253625