COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a hospital-based prospective cohort study

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Arun Tiwari1, Suma Balan1, Abdul Rauf2

  • 1Department of Rheumatology and Clinical Immunology, Amrita Institute of Medical Sciences, Cochin, Kerala, India.

BMJ Paediatrics Open
|October 25, 2021
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) following COVID-19 presents with diverse symptoms. While most children recover well, some experience echocardiographic changes, and hyperferritinemia indicates a need for mechanical ventilation.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition linked to COVID-19.
  • Understanding its epidemiology, clinical features, and outcomes is crucial for effective management.

Purpose of the Study:

  • To investigate the epidemiological factors, clinical profile, and outcomes of MIS-C in children.
  • To analyze clinical presentations across different age groups.
  • To assess medium-term outcomes and identify predictors of disease severity.

Main Methods:

  • A prospective cohort study was conducted at two tertiary care centers in Kerala, India.
  • 41 children diagnosed with MIS-C according to CDC criteria were enrolled.
  • Statistical analyses included chi-square/Fisher's exact tests and t-tests/Mann-Whitney tests, with Bonferroni's correction.

Main Results:

  • The study included 41 children with MIS-C (mean age 6.2 years); 80% were previously healthy.
  • Echocardiogram abnormalities were observed in 56%, with 37% showing coronary issues.
  • Intensive care was needed for 88%, mechanical ventilation for 20%, and 5% of patients died. Hyperferritinemia was linked to mechanical ventilation (p=0.001).

Conclusions:

  • MIS-C presents with a wide spectrum of illness, from mild symptoms to multiorgan dysfunction.
  • Outcomes are generally excellent, with most patients recovering, though some have residual echocardiographic changes.
  • Hyperferritinemia is a significant predictor for the need for mechanical ventilation in MIS-C patients.
Abstract

Keywords:
COVID-19

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