Multisystem inflammatory syndrome in children: clinical characteristics, diagnostic findings and therapeutic interventions at a tertiary care center in South of Italy
Pediatric Rheumatology
; 20(SUPPL 1), 2022.
Article
in English
| EMBASE | ID: covidwho-1677519
ABSTRACT
Introduction:
Multisystem inflammatory syndrome in children (MISC), also known as paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS), is a condition characterised by persistent fever, elevation of inflammatory indexes and evidence of organs involvement or shock.Objectives:
To describe clinical characteristics, diagnostic findings and therapeutic interventions of monocentric cohort of MIS-C.Methods:
Diagnosis of MIS-C was done following CDC criteria. Patients were hospitalised at Santobono-Pausilipon Children's Hospital in Naples, Italy, from November 2020 to March 2021.Results:
MIS-C was diagnosed in 29 patients, 14 males (48.3%). Mean age at diagnosis was 7,2 years old (range 4 months-12,9 years). Contact with SARS-CoV-2-positive patient emerged in 18/29 patients (62%) while 5/29 patients (17,2%) reported symptomatic COVID-19 in the weeks before. SARS-CoV-2 serologic assayrevealed IgG +/IgM- in 100% of the patients. No one presented concurrent conditions but obesity in 6/29 (20,7%). Mucocutaneous involvement was evidenced in 21/29 patients (72%), gastrointestinal symptoms 22/29 (75.9%), cardiac involvement in 27/29 (93,1%). The most frequent symptoms were fever (100%), conjunctivitis (65.5%), abdominal pain (62%), diarrhoea (48,2%), rash (44,9%), vomiting (31%) and cheilitis (31%). Laboratory findings are summarised in table 1. Troponin resulted elevated in 16/29 (55,1%), associated elevation of BNP was evidenced in 12/29 (62%). Electrocardiography showed alterations in 25/29 (86,2%) while echocardiography in 21/29 (72%). Concerning therapy, 27/29 (93%) patients underwent parenteral antibiotics at the admission. Intravenous immunoglobulin (IVIG) was performed in 25/29 (86,2%) of patients. Due to cardiac involvement 13/29 patients (44,8%) received bolus of steroids. 4/29 patients (13,8%) presented worsening of clinical and laboratoristic parameters during treatment with steroids, requiring Anakinra. One patient died due to cardiogenic shock at the admission.Conclusion:
Mucocutaneous, gastrointestinal and cardiac involvement are the most common manifestations in our cohort, as also reported in literature. Biologic treatment was necessary in minority of patients. MIS-C is a new emerging condition and represent a challenge to paediatricians due to the severity of presentation. More data are needed to better define incidence and prognosis of that condition.
anakinra; antibiotic agent; endogenous compound; human immunoglobulin; immunoglobulin G; immunoglobulin M; steroid; troponin; abdominal pain; cardiogenic shock; cheilitis; child; clinical article; clinical feature; conference abstract; conjunctivitis; controlled study; coronavirus disease 2019; diarrhea; drug therapy; echocardiography; electrocardiography; female; fever; gastrointestinal symptom; human; incidence; Italy; male; nonhuman; obesity; pediatric multisystem inflammatory syndrome; pediatrician; preschool child; prognosis; rash; school child; Severe acute respiratory syndrome coronavirus 2; tertiary care center; vomiting
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
/
Prognostic study
Language:
English
Journal:
Pediatric Rheumatology
Year:
2022
Document Type:
Article
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