Multisystem inflammatory syndrome associated with COVID-19 in children: Risk factors of severe life-threatening course of the disease
International Journal of Rheumatic Diseases
; 26(Supplement 1):192-193, 2023.
Article
in English
| EMBASE | ID: covidwho-2227752
ABSTRACT
Background/Purpose:
Multisystem inflammatory syndrome in children (MIS-C), associated with COVID-19 infection is a life-threatening condition, required intensive care. The aim of this study was to determine risk factors for severe/life-threatening course of MIS-C. Method(s) The retrospective study included 166 children (99 male, 67 female), aged from 4 months to 17 years (median 8.2 years), who met the WHO criteria for MIS-C. The criterion of severity was the fact of the ICU admission. The analysis of the obtained data was performed using the STATISTICA software package, version 10.0 (StatSoft Inc., USA). Result(s) To assess the factors associated with the severe course of MIS-C, patients were divided into two groups those who were hospitalized in the ICU (n = 84;50.6%), and those who did not (n = 82;49.4%). Patients with a more severe course of MIS-C were significantly older. They had a high frequency of signs such as rash, edema, hepatomegaly, splenomegaly, neurological and respiratory symptoms. Hypotension/shock and myocardial damage were much more common in patients hospitalized in the ICU. Among the laboratory changes there were significant differences in the levels of hemoglobin, leukocytes and platelets, CRP, creatinine, troponin and D-dimer. The presence of macrophage activation syndrome was higher in patients, admitted in the ICU. Children, required intensive care required high dose corticosteroids and IVIG more often (table 1). FIGURE 1) The first symptoms of progeria in infancy scleroderma-like changes in the skin of the lower extremities and stiffness of knee joints at the age of 2 months. 2) Girl at the age of 3 years 5 months. Almost total alopecia with the absence of eyebrows and eyelashes. Pronounced venous pattern in the forehead, nasal bridge and nasolabial triangle. Conclusion(s) MIS-C is potentially a severe life-threatening condition, in which more than half (50.6%) of patients needed the ICU admission. The main factors determining the severity of MIS-C were cardiovascular, resiratory and central nervous system disorders. It has been found that factors such as hepatomegaly, splenomegaly, D-dimer >2568 ng/ml, troponin >10 pg/ml, make it possible to identify a group of patients with high risk of severe MIS-C who may potentially need hospitalization in the ICU.
adolescent; alopecia; central nervous system disease; child; conference abstract; controlled study; coronavirus disease 2019; drug megadose; edema; eyebrow; eyelash; female; forehead; gene expression; heart muscle injury; hepatomegaly; hospitalization; human; human cell; hypotension; infancy; intensive care; knee; leukocyte; lower limb; macrophage activation syndrome; major clinical study; male; neurologic disease; pediatric multisystem inflammatory syndrome; preschool child; progeria; protein expression; rash; retrospective study; rigidity; risk factor; scleroderma; software; splenomegaly; systemic inflammatory response syndrome; thrombocyte; corticosteroid; creatinine; D dimer; endogenous compound; hemoglobin; human immunoglobulin; troponin
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
International Journal of Rheumatic Diseases
Year:
2023
Document Type:
Article
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