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First Tunisian Cluster Admissions of Critically Ill Patients with Multisystem Inflammatory Syndrome in Children
Aida Borgi1, Hend Khadhraoui1, Assaad Louati1
1Pediatric intensive care unit, Children's Hospital Béchir Hamza of Tunis - Faculty of Medicine of Tunis-University of Tunis of EL-Manar. Tunis.
Insights
This study reports on 8 critically ill children in Tunisia with Multisystem Inflammatory Syndrome in Children (MIS-C), a severe condition linked to COVID-19. All patients recovered, highlighting the emergence of this disease in older children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Pediatric rheumatology
Background:
- Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe, emerging condition associated with prior COVID-19 infection.
- Understanding MIS-C clinical presentations and outcomes is crucial for timely diagnosis and management.
Purpose of the Study:
- To characterize the clinical features, laboratory findings, treatments, and outcomes of the first cluster of critically ill children with MIS-C in Tunisia.
- To identify key indicators of severe MIS-C in pediatric patients.
Main Methods:
- A retrospective study was conducted on eight children under 15 admitted to a pediatric intensive care unit meeting WHO MIS-C criteria.
- Patient medical records were reviewed for demographic data, clinical presentation, laboratory results, echocardiographic findings, treatments, and outcomes.
Main Results:
- The median age of affected children was 8 years; all were previously healthy.
- Common symptoms included fever, gastrointestinal issues (diarrhea, abdominal pain), rash, conjunctivitis, and cheilitis.
- Cardiac dysfunction (7/8) and shock (3/8) were significant findings; all received immunoglobulins and corticosteroids, with no deaths.
Conclusions:
- This study presents the first Tunisian cluster of critically ill children with MIS-C, indicating a rise in this severe post-COVID-19 condition.
- MIS-C affects older children and presents with significant cardiac involvement, emphasizing the need for heightened awareness and prompt intervention.
Background:
Multisystem inflammatory syndrome in children (MIS-C) is a new emerging severe disease that is temporally related to previous exposure to coronavirus infection disease (COVID-19).
Aim:
To describe the clinical features, laboratory findings, therapies, and outcomes for the first Tunisian cluster admissions of critically ill children with severe MIS-C.
Methods:
Retrospective study conducted from November 01 to November 30, 2020According to the WHO definition case, we included eight children aged less than 15 years who were admitted to our pediatric intensive care and met MIS-C criteria. We reviewed all patients' medical records to collect demographic and clinical data, severity scores, laboratory test results, echocardiographic findings, treatment, and outcomes.
Results:
The median age was 8 years (IQR: 4-10years). All children were previously fit and well. Seven patients were boys. Known exposure to COVID-19 was reported in 4 cases. Fever and gastrointestinal symptoms were reported in all cases. Five patients had marked abdominal pain and were examined by the surgeon for possible appendicitis. Seven patients had diarrhea. On examination, we found rash (n=7), conjunctivitis (n=7), cheilitis (n=5), and meningism (n=3). We reported cardiac dysfunction in 7 cases and shock with hypotension in 3 cases. All patients received immunoglobulins, methylprednisolone, and a low dose of aspirin. No deaths occurred.
Conclusion:
We reported here the first Tunisian cluster admissions of 8 critically ill children with MIS-C to highlight the increase of a new severe emerging disease with evidence of prior COVID-19 infection in older children.
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