Multisystem Inflammatory Syndrome in Children associated with COVID-19: A comparison study between cohorts from different geographic locations

ABSTRACT

Introduction. We aim to evaluate the sociodemographic and clinical differences between hospitalized children with multisystem inflammatory syndrome in children (MIS-C) in the United States vs. Colombia. Materials and methods. Multicenter prospective observational study of children diagnosed with MIS-C' according to the US CDC definition were enrolled between 03Mar2020-06Apr2022 at one US site (Connecticut Children's Medical Center [CT cohort]) and two Colombian sites (Clinica Imbanaco [CI] and Hospital Universitario del Valle [HUV] in Cali [CI/HUV cohort]). Data was collected in a standardized' online case-collection form developed in REDCap. Cohorts were compared using Fisher's Exact test or Mann-Whitney U test as appropriate. Results. Sixty-four MIS-C cases were included' 40 in CT and 24 in CI/HUV. Median age was 8.6 years (IQR 5,3-13,0)' 53% were male' and almost one-third had a co-morbid condition. A higher median BMI and obesity prevalence were reported in the CT cohort. Overall' most children presented with fever' mucocutaneous findings' or gastrointestinal symptoms. 13% had systolic hypotension. More children in the CI/HUV cohort presented with upper respiratory symptoms compared to the CT cohort (88% vs 28%) while fewer presented with systemic symptoms (50% vs 85%). Laboratory and radiologic findings were similar across both cohorts. Children in the CT cohort received steroids' combined IVIg/steroids' and antibiotics more frequently. Outcomes were similar across both cohorts' except for a longer hospital stay in the CI/HUV cohort. Conclusions. Despite different interventions in comparable cohorts' outcomes were similar. Data from larger studies are needed to evaluate whether these differences are intrinsic to individual conditions or different treatment protocols.