Clinical characteristics, treatment response and short-term general and cardiac outcomes in multisystem inflammatory syndrome in children (MIS-C)

ABSTRACT

Background and Aim: In April 2020, clinicians in the United Kingdom observed a group of children with hyperinflammatory shock with significant cardiovascular effects, with features similar to Kawasaki disease and toxic shock syndrome. This new syn-drome that is temporally related to previous exposure to SARS-CoV-2 infection, is now known as multisystem inflammatory syn-drome in children (MIS-C). The aim of this study is to describe the incidence, the clinical, laboratory and echocardiografic character-istics of hospitalized children who met criteria for the MIS-C and analyse short time general and cardiac outcomes in our region. Method(s) Data from children admitted who fulfilled the case def-inition of MIS-C were collected between October 2020 and November 2021. Result(s) 10 cases of MIS-C were reported;the incidence of MIS-C during this period was 1 per 10000 positive sars-cov2 cases (diag-nosed by polymerase chain reaction test or antigen test). The median age was 10 years (IQR 6-12). 70% were male and 50% corresponded to ethnic minority group in our country (20% Latin American and 30% African). 8 of 10 patients (80%) had evi-dence of current or prior SARS-CoV-2 infection and 2 of 10 (20%) had an antecedent of contact with a COVID positive patient. Fever (100% patients), hematologic disturbances (90%), cardiac involvement (biochemical or echocardiographic) (80%), gastrointestinal (80%) and mucocutaneus (50%) symptoms were common presenting features. 8 of 10 were admitted in the pedi-atric intensive care unit. When referring to cardiovascular involve-ment, 1 of 10 (10%) patients had left ventricular systolic dysfunction, 2 of 10 (20%) had mild pericardial effusion and 4 of 10 (40%) mild coronary artery abnormalities. Conclusion(s) Although the incidence is low, in this case series most patients show homogeneous clinical and laboratory findings. Since cardiac involvement is described in a high proportion of patients, long-term follow-up is required due to the unclear prognosis and risk of progression of cardiac manifestation.