Multisystem Inflammatory Syndrome in Three Pediatric Intensive Care Units in Quito, Ecuador

ABSTRACT

BACKGROUND AND AIM: Multisystem inflammatory syndrome (MIS-C) associated to SARS-CoV-2, has significant morbidity in children. The aim was to assess clinical and outcomes patients admitted Ecuadorian Pediatric Intensive Care Units (PICUs), to stablish some information about this pathology in our country. METHOD(S) An observational, retrospective cohort study with 3 institutions. Between August 2020 and June 2021. 108 patients met the WHO criteria for diagnosis. Children from 1 month to 15 years old were included. The sample distribution was Hospital Pediatrico Baca Ortiz (HPBO, n=98), Hospital Metropolitano (HM, n=7), and Hospital Ingles (HI, n=3). Demographic data, clinical presentation, laboratory test, treatment, morbidity, and mortality were obtained. RESULT(S) From the 108 patients included, 34% were infants, 64% male, and 47.3% with comorbidities. Epilepsy was found in 17.3%, asthma in 2.94%, and diabetes 2%. Polymerase chain reaction for SARS-CoV-2 was negative in 82%. All children received methylprednisolone at different dosing protocols, 48% received intravenous immunoglobulin (IVIG);from the 108 patients, 33% had dilatation of the coronary arteries, respiratory compromise in 50%, and 0,9 % present neurological signs. Shock was present on 88%. CONCLUSION(S) Shock was the complication most frequently involve on MIS-C. Despite the use of IVIG, one third of the patients who receive this treatment present coronary artery dilation, more research is needed to determine predisposing factors. Methylprednisolone was used on different dosing without relationship with favorable outcome. Epilepsy was the major mortality. Institutions had the same diagnostic criteria for MIS-C, but a standardized protocol of treatment is needed to improve the general outcome. (Table Presented).