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Multisystem Inflammatory Syndrome in Children Associated with COVID-19 in a Tertiary Level Hospital in Portugal

Joana Vieira de Melo1, Rita Valsassina1, Ana Margarida Garcia1

  • 1Unidade de Infecciologia Pediátrica. Hospital Dona Estefânia. Centro Hospitalar Universitário Lisboa Central. Lisboa. Portugal.

Acta Medica Portuguesa
|May 31, 2022
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) is a severe COVID-19 complication. Most affected children were previously healthy, presenting with multi-organ involvement, but a small percentage experienced severe illness, highlighting the need for prompt diagnosis and treatment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe manifestation of COVID-19.
  • Understanding MIS-C characteristics is crucial for timely diagnosis and management.

Purpose of the Study:

  • To describe the clinical and demographic characteristics of children diagnosed with MIS-C.
  • To analyze organ system involvement and identify factors associated with severe disease presentation.

Main Methods:

  • An observational descriptive study was conducted on 45 MIS-C patients admitted between April 2020 and April 2021.
  • Data collected included demographics, clinical features, diagnostic tests, and treatment protocols, adhering to WHO and CDC criteria.

Main Results:

  • The median age of MIS-C patients was seven years, with 60% being previously healthy. Common organ involvement included hematologic (100%), cardiovascular (97.8%), and gastrointestinal (97.8%) systems.
  • Neurological and respiratory involvement correlated with more severe presentations. Laboratory markers like D-dimer, CRP, and IL-6 differed significantly between severity groups.
  • While most patients received intravenous immunoglobulin and methylprednisolone, 28.8% required intensive care. Notably, 53.3% of those with cardiac MRI showed sequelae, and 90.4% had reduced exercise capacity.

Conclusions:

  • MIS-C presents a wide spectrum of illness, often in previously healthy children.
  • A significant minority (28.9%) experienced severe disease, emphasizing the need for high clinical suspicion for early diagnosis.
  • The lack of consensus on treatment and follow-up poses challenges, underscoring the importance of timely therapeutic initiation to prevent complications.
Abstract

Keywords:
COVID-19/complicationsChildSARS-CoV-2Systemic Inflammatory Response Syndrome

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