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Spectrum of SARS-CoV-2-Related Clinical Syndromes in Children: A Year in the Life

Mahjabeen Khan1,2, LeQuan Dang1,2, Harjinderpal Singh2

  • 1SSM Health Cardinal Glennon Children's Hospital, Saint Louis, MO, USA.

Clinical Pediatrics
|December 3, 2021
PubMed

Insights

Pediatric SARS-CoV-2 infections present diverse clinical pictures, including COVID-19 and MIS-C. Multisystem inflammatory syndrome in children (MIS-C) patients showed higher inflammatory markers and critical care needs compared to COVID-19.

Area of Science:

  • Pediatric Infectious Diseases
  • Viral Syndromes in Children
  • Public Health Surveillance

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibits a broad clinical spectrum in pediatric populations.
  • Initial observations indicated milder symptoms in children, but the emergence of multisystem inflammatory syndrome in children (MIS-C) highlighted a more severe presentation.

Purpose of the Study:

  • To investigate the demographic and clinical characteristics of pediatric patients diagnosed with SARS-CoV-2-associated conditions.
  • To differentiate between coronavirus disease 2019 (COVID-19) and MIS-C based on clinical presentation and laboratory findings.

Main Methods:

  • Retrospective cohort study of hospitalized pediatric patients over one year.
  • Classification of patients into COVID-19 (non-MIS-C) and MIS-C cohorts based on clinical syndrome.
  • Analysis of demographic data, clinical symptoms, inflammatory markers, and patient outcomes.

Main Results:

  • Sixty-seven percent of SARS-CoV-2 positive patients were symptomatic.
  • Multisystem inflammatory syndrome in children (MIS-C) was diagnosed in 24 patients.
  • Both COVID-19 and MIS-C were more prevalent in Caucasian children, with distinct symptom profiles and inflammatory marker levels.
  • MIS-C patients exhibited significantly higher inflammatory markers, critical care requirements, and longer hospital stays.
  • COVID-19 cohort predominantly showed respiratory complications, whereas the MIS-C cohort presented with cardiovascular involvement.

Conclusions:

  • Pediatric SARS-CoV-2 infections manifest in distinct clinical syndromes: COVID-19 and MIS-C.
  • Multisystem inflammatory syndrome in children (MIS-C) is associated with heightened inflammation and critical illness, particularly cardiovascular complications.
  • Increased healthcare provider awareness is crucial for the early recognition, diagnosis, and timely management of both pediatric COVID-19 and MIS-C.

Keywords:
COVID-19Multi-system inflammatory syndrome in childrenSARS-CoV-2

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