Multisystem Inflammatory Syndrome in Children in New York State

Area of Science:

• Pediatric critical care
• Infectious diseases
• Public health surveillance

Background:

• A novel multisystem inflammatory syndrome in children (MIS-C) emerged in association with coronavirus disease 2019 (COVID-19).
• New York State Department of Health (NYSDOH) initiated active, statewide surveillance to characterize hospitalized MIS-C patients.
• Surveillance captured cases resembling Kawasaki's disease, toxic shock syndrome, and myocarditis in pediatric patients.

Purpose of the Study:

• To describe the clinical presentation, complications, and outcomes of hospitalized children with MIS-C.
• To analyze demographic and clinical data of MIS-C cases reported to NYSDOH.
• To understand the epidemiology of MIS-C in New York State during the early pandemic.

Main Methods:

• Descriptive analysis of hospitalized patients meeting the NYSDOH MIS-C case definition.
• Data collection from hospitals including clinical presentation, laboratory results, and outcomes.
• Analysis of cases reported between March 1 and May 10, 2020.

Main Results:

• 191 potential cases reported; 99 met MIS-C criteria (95 confirmed, 4 suspected).
• Majority of confirmed cases were male (54%), Black (40%), and Hispanic (36%), with a peak incidence in the 6-12 year age group (42%).
• Common symptoms included fever, tachycardia, gastrointestinal distress, rash, and conjunctivitis; 53% had myocarditis, 80% required ICU admission, and 2 deaths occurred.

Conclusions:

• MIS-C emerged in New York State concurrent with widespread SARS-CoV-2 transmission.
• The syndrome presented as a hyperinflammatory state with dermatologic, mucocutaneous, and gastrointestinal manifestations.
• Cardiac dysfunction was a significant complication associated with MIS-C in this pediatric cohort.