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SARS-CoV-2 associated multisystem inflammatory syndrome in children (MIS-C). A single center's experience
Sevliya Öcal Demir1, Öykü Tosun2, Kübra Öztürk3
1Pediatric Infectious Diseases, Pediatric Department, SB Istanbul Medeniyet University Goztepe Prof Dr Suleyman Yalcın City Hospital, Istanbul, Turkey - sevliyademir@gmail.com.
Insights
Multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 requires prompt recognition. Glucocorticoids significantly improve outcomes, reducing intensive care needs and accelerating recovery.
Area of Science:
- Pediatric rheumatology
- Infectious diseases
- Pediatric critical care
Background:
- SARS-CoV-2 related multisystem inflammatory syndrome in children (MIS-C) is a serious condition resembling Kawasaki disease.
- Early recognition and awareness of MIS-C are crucial for effective management.
Purpose of the Study:
- To raise awareness about SARS-CoV-2 related MIS-C.
- To describe the clinical characteristics, treatment, and outcomes of children with MIS-C.
Main Methods:
- Retrospective study of 20 children diagnosed with MIS-C between November 2020 and January 2021.
- Data collected included demographics, clinical and laboratory findings, treatments, and outcomes.
Main Results:
- Common symptoms included fever, abdominal pain, myalgia, and rash. Cardiac involvement (90%) was prevalent.
- Glucocorticoids showed a dramatic effect, unlike intravenous immunoglobulin (IVIG). Seven patients (35%) required intensive care.
- Median recovery time was 9.5 days. No patients required intubation or mechanical ventilation.
Conclusions:
- Glucocorticoids play a critical role in treating MIS-C.
- Early diagnosis and treatment with glucocorticoids can reduce the need for intensive care and promote rapid recovery.
Background:
SARS-CoV-2 related multisystem inflammatory syndrome in children (MIS-C) is a newly defined clinical entity in pediatric ages resembles Kawasaki Disease or toxic shock syndrome. Here we aimed to raise awareness about this SARS-CoV-2 related syndrome.
Methods:
Children diagnosed with MIS-C and followed in Pediatric Clinic between November 2020 and January 2021, were included in study. Data about patients' demographic characteristics, clinical and laboratory findings, treatment and outcomes were collected from medical records.
Results:
The median age of 20 children with MIS-C was 80.5 months, 11 of them were male. The most common symptoms at admission were fever (100%), abdominal pain (70%), myalgia (50%), and rash (50%). Lymphopenia, elevated inflammatory markers and cardiac enzymes were their main laboratory findings. Cardiac involvement (90%) consisted of myopericarditis, valvulitis, left ventricular dysfunction, and coronary arteritis. Symptoms mimicking acute appendicitis and ileus were due to gastrointestinal involvement (50%). Macular rash on the trunk, erythema on upper eyelids were striking. Empiric antibiotics and intravenous immunoglobulin were used in all patients, glucocorticoids (90%), anti-thrombotic (65%) and vasoactive (45%) agents were used according to severity of disease. Response to IVIG treatment was poor, whereas glucocorticoids have dramatic affect. Seven patients (35%) were monitored in intensive care unit, none of them required intubation, mechanic ventilation or ECMO. The median recovery time, that is, the period when fever subside and inflammatory markers returned to normal was 9.5 days.
Conclusions:
Glucocorticoids has critical role in treatment of MIS-C, early recognition and treatment may decrease need for intensive care by providing rapid recovery.
