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Distinct characteristics of multisystem inflammatory syndrome in children in Poland
Kamila Maria Ludwikowska1, Magdalena Okarska-Napierała2, Natalia Dudek2
1Department of Pediatric Infectious Diseases, Wroclaw Medical University, Chałubińskiego 2-2a, 50-368, Wrocław, Poland.
Insights
Multisystem inflammatory syndrome in children (MIS-C) in Poland affected mostly boys. While generally less severe, older boys showed distinct cardiac and macrophage activation syndrome symptoms, suggesting tailored treatment approaches.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- A significant wave of multisystem inflammatory syndrome in children (MIS-C) occurred in Poland during the 2020/2021 winter.
- Previous reports indicated severe disease courses for MIS-C.
Purpose of the Study:
- To characterize MIS-C cases in Poland.
- To identify determinants of MIS-C severity and clinical presentation.
Main Methods:
- A nationwide register was utilized to collect data on 274 children diagnosed with MIS-C.
- Clinical data, including demographics, symptoms, and treatment requirements, were analyzed.
Main Results:
- The Polish MIS-C cohort (62.8% boys, median age 8.8 years) showed a less severe course than previously reported, with only 8.4% requiring pediatric intensive care.
- Older children requiring intensive care presented with distinct clinical features.
- Sex-dependent differences were observed: teenage boys had higher rates of cardiac involvement and macrophage activation syndrome.
Conclusions:
- While MIS-C in Poland was less severe overall, specific demographic factors like age and sex influence disease presentation and severity.
- Management protocols for MIS-C may need population-specific adjustments rather than universal application.
Abstract:
During the winter months of 2020/2021 a wave of multisystem inflammatory syndrome in children (MIS-C) emerged in Poland. We present the results of a nationwide register aiming to capture and characterise MIS-C with a focus on severity determinants. The first MIS-C wave in Poland was notably high, hence our analysis involved 274 children. The group was 62.8% boys, with a median age of 8.8 years. Besides one Asian, all were White. Overall, the disease course was not as severe as in previous reports, however. Pediatric intensive care treatment was required for merely 23 (8.4%) of children, who were older and exhibited a distinguished clinical picture at hospital admission. We have also identified sex-dependent differences; teenage boys more often had cardiac involvement (decreased ejection fraction in 25.9% vs. 14.7%) and fulfilled macrophage activation syndrome definition (31.0% vs. 15.2%). Among all boys, those hospitalized in pediatric intensive care unit were significantly older (median 11.2 vs. 9.1 years). Henceforth, while ethnicity and sex may affect MIS-C phenotype, management protocols might be not universally applicable, and should rather be adjusted to the specific population.
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