Multisystem Inflammatory Syndrome in Children With COVID-19 in Mumbai, India

Area of Science:

• Pediatric Infectious Diseases
• Critical Care Medicine
• Cardiology

Background:

• Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 is a serious condition requiring prompt recognition and management.
• Limited data exists on MIS-C presentation and outcomes in the Indian subcontinent.

Purpose of the Study:

• To describe the clinical presentation, treatment strategies, and outcomes of pediatric patients diagnosed with MIS-C in the Mumbai metropolitan area.
• To identify clinical and laboratory factors associated with severe disease presentation in MIS-C.

Main Methods:

• An observational study was conducted involving 23 pediatric patients diagnosed with MIS-C according to WHO criteria.
• Data on demographics, clinical symptoms, laboratory markers, treatments, and outcomes were collected retrospectively from hospital records.
• Statistical analysis was performed to compare characteristics between patients with and without shock.

Main Results:

• 23 children (median age 7.2 years) were included; 39.1% had positive COVID-19 RT-PCR and 30.4% had positive antibody tests.
• 65% of patients presented in shock, associated with higher age, myocarditis, elevated cardiac biomarkers, and specific white blood cell count abnormalities.
• Coronary artery dilation occurred in 26% of patients. Treatment predominantly involved steroids (96%) and intravenous immunoglobulin (IVIg) (65%).

Conclusions:

• This study provides initial insights into MIS-C in India, highlighting a high prevalence of shock and cardiac involvement.
• Steroid and IVIg therapy appeared effective, leading to a favorable outcome with a single mortality.
• Further research and extended surveillance are crucial for refining diagnostic, treatment, and monitoring guidelines for MIS-C.