Eastern India Collaboration on Multisystem Inflammatory Syndrome in Children (EICOMISC): A Multicenter Observational...

Area of Science:

• Pediatrics
• Infectious Diseases
• Cardiology

Background:

• Limited data exists on multisystem inflammatory syndrome in children (MIS-C) epidemiology and outcomes, especially from resource-poor settings.
• Multi-center studies on MIS-C are scarce, particularly within the Indian context.

Purpose of the Study:

• To investigate the epidemiology, clinical features, and outcomes of MIS-C in children.
• To identify factors associated with mortality in MIS-C cases.

Main Methods:

• A retrospective collaborative study involving 134 children (≤15 years) diagnosed with MIS-C across five tertiary care hospitals in Eastern India.
• Data collection focused on clinical presentation, comorbidities, treatment, and mortality, adhering to WHO criteria for MIS-C.
• Primary outcome measure was mortality; secondary outcomes included coronary artery abnormalities and treatment response.

Main Results:

• Fever was universal; common symptoms included conjunctivitis (71%), gastro-intestinal (50.7%), and respiratory (39.6%) issues. Shock occurred in 35% of cases.
• Mortality was 11.2%, with comorbidities, lymphopenia, thrombocytosis, hyponatremia, elevated LDH, and hypoalbuminemia significantly linked to increased mortality.
• Coronary abnormalities resolved in most cases; immunomodulation choice (steroids, IVIg) did not significantly impact outcomes.

Conclusions:

• MIS-C exhibits a wide range of clinical manifestations.
• Specific laboratory findings and comorbidities are critical predictors of mortality in MIS-C.
• Coronary artery abnormalities are generally reversible, and current immunomodulatory treatments show no significant difference in outcomes.