A Comparative Study of Children with MIS-C between Admitted to the Pediatric Intensive Care Unit and Pediatric Ward: A One-Year Retrospective Study
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Elif Kıymet1, Elif Böncüoğlu1, Şahika Şahinkaya1
1Department of Paediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children's Hospital, İzmir 35210, Turkey.
Insights
Multisystem inflammatory syndrome in children (MIS-C) requiring pediatric intensive care unit (PICU) admission showed higher pulmonary involvement and shock signs. Laboratory markers like C-reactive protein and ferritin were significantly elevated in the PICU group, indicating severe illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious condition following SARS-CoV-2 infection.
- Understanding factors predicting pediatric intensive care unit (PICU) admission is crucial for timely intervention.
- Previous studies highlighted cardiac dysfunction, but pulmonary and shock involvement require further investigation.
Purpose of the Study:
- To compare clinical and laboratory features of MIS-C patients with and without PICU admission.
- To identify predictors of severe MIS-C requiring intensive care.
Main Methods:
- A descriptive study included 58 hospitalized children (≤18 years) diagnosed with MIS-C.
- Data collected from electronic medical records included demographics, symptoms, and laboratory findings.
- Patients were categorized into PICU and non-PICU groups for comparative analysis.
Main Results:
- Fifteen patients (25.9%) required PICU admission.
- Pulmonary involvement was significantly higher in the PICU group (81.3%).
- Elevated procalcitonin, C-reactive protein, ESR, D-Dimer, and ferritin levels were observed in the PICU group (p < 0.05).
Conclusions:
- Pulmonary involvement and signs of shock are key indicators for PICU admission in children with MIS-C.
- Elevated inflammatory markers suggest a more severe disease course in PICU-admitted patients.
- These findings aid in early identification and management of severe MIS-C cases.
Objectives:
This descriptive study aimed to compare the clinical and laboratory features of the children with the multisystem inflammatory syndrome in children (MIS-C), requiring pediatric intensive care unit (PICU), admission with the MIS-C patients who did not require PICU admission.
Patients And Methods:
This study was conducted between March 2020 and February 2021 at the University of Health Sciences Dr. Behçet Uz Children's Hospital, a referral center for pediatric infectious diseases in the Aegean Region of Turkey. All hospitalized patients aged 18 years old or less with MIS-C according to the definition of the universal guidelines were included in the study. Data of the patients with the diagnosis of MIS-C were recorded and collected from the electronic medical records of the hospital. The data included demographic characteristics, presenting signs and symptoms, laboratory findings and clinical data.
Results:
A total of 58 patients with MIS-C were included in this study. Thirty-eight (65.5%) patients were male. The median age was 6 years (2 months-16 years). The patients admitted to PICU were 15 (25.9%). The rate of pulmonary involvement was 81.3% (n = 13) in the PICU group. The median procalcitonin, C-reactive protein, erythrocyte sedimentation rate, D-Dimer and ferritin values were significantly higher in the PICU group compared to non-PICU group (p < 0.001, p = 0.02, p < 0.001, p = 0.006 and p = 0.031).
Conclusions:
Besides the depressing cardiac functions reported before, the pulmonary involvement and signs of shock are important factors for PICU admission in children with MIS-C.
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