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Characteristics and Outcomes of Critically Ill Children With Multisystem Inflammatory Syndrome.
Snooks, Kellie; Scanlon, Matthew C; Remy, Kenneth E; Shein, Steven L; Klein, Margaret J; Zee-Cheng, Janine; Rogerson, Colin M; Rotta, Alexandre T; Lin, Anna; McCluskey, Casey K; Carroll, Christopher L.
  • Snooks K; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
  • Scanlon MC; Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
  • Remy KE; Department of Pediatrics, Case Western University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH.
  • Shein SL; Department of Pediatrics, Case Western University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH.
  • Klein MJ; Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
  • Zee-Cheng J; Department of Pediatrics, Indiana University of School of Medicine, Indianapolis, IN.
  • Rogerson CM; Department of Pediatrics, Indiana University of School of Medicine, Indianapolis, IN.
  • Rotta AT; Department of Pediatrics, Duke University School of Medicine, Durham, NC.
  • Lin A; Department of Pediatrics, Stanford University, Palo Alto, CA.
  • McCluskey CK; Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV.
  • Carroll CL; Department of Pediatrics, Connecticut Children's, Hartford, CT.
Pediatr Crit Care Med ; 23(11): e530-e535, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2097528
ABSTRACT

OBJECTIVES:

To characterize the prevalence of pediatric critical illness from multisystem inflammatory syndrome in children (MIS-C) and to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain on outcomes.

DESIGN:

Retrospective cohort study.

SETTING:

Database evaluation using the Virtual Pediatric Systems Database. PATIENTS All children with MIS-C admitted to the PICU in 115 contributing hospitals between January 1, 2020, and June 30, 2021. MEASUREMENTS AND MAIN

RESULTS:

Of the 145,580 children admitted to the PICU during the study period, 1,338 children (0.9%) were admitted with MIS-C with the largest numbers of children admitted in quarter 1 (Q1) of 2021 ( n = 626). The original SARS-CoV-2 viral strain and the D614G Strain were the predominant strains through 2020, with Alpha B.1.1.7 predominating in Q1 and quarter 2 (Q2) of 2021. Overall, the median PICU length of stay (LOS) was 2.7 days (25-75% interquartile range [IQR], 1.6-4.7 d) with a median hospital LOS of 6.6 days (25-75% IQR, 4.7-9.3 d); 15.2% received mechanical ventilation with a median duration of mechanical ventilation of 3.1 days (25-75% IQR, 1.9-5.8 d), and there were 11 hospital deaths. During the study period, there was a significant decrease in the median PICU and hospital LOS and a decrease in the frequency of mechanical ventilation, with the most significant decrease occurring between quarter 3 and quarter 4 (Q4) of 2020. Children admitted to a PICU from the general care floor or from another ICU/step-down unit had longer PICU LOS than those admitted directly from an emergency department.

CONCLUSIONS:

Overall mortality from MIS-C was low, but the disease burden was high. There was a peak in MIS-C cases during Q1 of 2021, following a shift in viral strains in Q1 of 2021. However, an improvement in MIS-C outcomes starting in Q4 of 2020 suggests that viral strain was not the driving factor for outcomes in this population.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Child / Humans Language: English Journal: Pediatr Crit Care Med Journal subject: Pediatrics / Critical Care Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Child / Humans Language: English Journal: Pediatr Crit Care Med Journal subject: Pediatrics / Critical Care Year: 2022 Document Type: Article