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Comparison of First and Second Wave Cohorts of Multisystem Inflammatory Disease Syndrome IN Children
Ashraf S Harahsheh1,2, Matthew P Sharron2,3, James E Bost2,4
1From the Division of Cardiology, Children's National Hospital, Washington, DC.
Insights
The second wave of pediatric Multisystem Inflammatory Syndrome in Children (MIS-C) patients were older and more severely ill, requiring more advanced support. However, both MIS-C waves showed similar outcomes regarding cardiac issues and hospital stay duration.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Cardiology
Background:
- Multisystem Inflammatory Syndrome in Children (MIS-C) emerged during the COVID-19 pandemic.
- Understanding the evolution of MIS-C clinical presentation and severity is crucial.
Purpose of the Study:
- To compare clinical characteristics and outcomes between the first and second waves of MIS-C patients.
- To identify changes in disease severity and patient demographics over time.
Main Methods:
- Retrospective cohort study comparing two distinct time periods of MIS-C cases.
- Analysis of patient demographics, clinical presentation, laboratory values, and treatment requirements.
- Assessment of cardiac involvement, including coronary artery abnormalities and systolic dysfunction.
Main Results:
- The second MIS-C cohort was older and presented with increased respiratory symptoms and cardiac biomarkers (troponin, N-terminal BNP).
- Second wave patients more frequently required advanced respiratory and inotropic support.
- Despite increased severity, both cohorts exhibited similar rates of coronary artery abnormalities, systolic dysfunction, and length of stay.
Conclusions:
- While the second wave of MIS-C indicated increased illness severity and need for advanced support, long-term cardiac sequelae and hospitalization duration remained comparable.
- This suggests potential shifts in MIS-C pathophysiology or host response over successive pandemic waves.
Abstract:
Comparing first and second wave MIS-C cohorts at our quaternary pediatric institution, second wave were older, presented more frequently with shortness of breath, higher maximum troponin and N-terminal BNP, and more frequently required advanced respiratory and inotropic support. Despite increased severity in the second cohort, both cohorts had similar rates of coronary artery abnormalities, systolic dysfunction, and length of stay.
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