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Clinical Features of Multisystem Inflammatory Syndrome in Children Associated with COVID-19 in Indonesia
Nina Dwi Putri1, Yogi Prawira1, Tartila Tartila1
1Department of Child Health, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Insights
Multisystem inflammatory syndrome in children (MIS-C) cases are rising globally but remain low in Indonesia. This study details MIS-C patient characteristics, revealing distinct clinical courses and outcomes in Indonesian children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a growing global concern.
- Reported cases of MIS-C remain notably low in Asian countries, especially Indonesia.
Purpose of the Study:
- To characterize patients diagnosed with MIS-C at a major Indonesian tertiary referral hospital.
- To identify factors influencing clinical course and outcomes in Indonesian MIS-C patients.
Main Methods:
- A cross-sectional study was conducted, analyzing data from MIS-C patients admitted between March 2020 and April 2021.
- Data included patient demographics, clinical presentation, laboratory markers, and treatment interventions.
Main Results:
- Thirteen MIS-C cases were identified among 158 COVID-19 admissions, with a 15% fatality rate.
- Patients were predominantly male, with a median age of 7.58 years; most required mechanical ventilation and intubation.
- Elevated inflammatory markers and coagulation parameters were observed; survivors had quicker diagnoses and different treatment trajectories than non-survivors.
Conclusions:
- Significant differences exist in the clinical course, treatment, and outcomes of MIS-C between survivor and non-survivor groups.
- This study provides crucial insights into MIS-C epidemiology and clinical management in Indonesia.
Background:
While the number of cases of multisystem inflammatory syndrome in children (MIS-C) is increasing, reported cases in Asian countries are still low, particularly in Indonesia. This study aimed to describe the characteristics of patients with MIS-C in a tertiary referral hospital in Indonesia.
Methods:
This is a cross-sectional study with collected data of patients with MIS-C admitted to Dr. Cipto Mangunkusumo from March 2020 to April 2021.
Results:
The first case of MIS-C was detected 5 months after the first reported coronavirus disease 2019 case in Indonesia. Thirteen patients out of 158 positive admitted patients for COVID-19 were diagnosed with MIS-C during the study period. Of these 13 patients, 2 patients (15%) had a fatal outcome. Subjects were predominantly male, and the median age was 7.58 years (IQR 12.3) years. Most patients required mechanical ventilation (7 out of 13 patients) and intubation (8 out of 13 patients). Patients who needed intubation usually needed mechanical ventilation. All inflammatory markers, white blood cells, neutrophil counts, and all coagulation factor parameters (except for normal prothrombin time and activated partial prothrombin time) were elevated. The median time to MIS-C diagnosis was 2 days in the survivor group (n = 11) compared to 8.5 days in the non-survivor group (n = 2). Compared to the non-survivor group, those who survived spent more days in the hospital, received vasopressors earlier, and did not require mechanical ventilation as early as the non-survivors.
Conclusions:
Our work highlights the differences in MIS-C clinical course, treatment, and clinical outcomes between the two groups.
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