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Multisystem Inflammatory Syndrome in Children (MIS-C) Related to SARS-CoV-2 and 1-Year Follow-up

Rashmi Kapoor1, Tarun Chandra2, Chandra Prakash Singh2

  • 1Department of Pediatrics, Regency Hospital, A-2, Sarvodaya Nagar, Kanpur, Uttar Pradesh, 208005, India. rashmiregency@gmail.com.

Indian Journal of Pediatrics
|December 9, 2022
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) is a serious COVID-19 complication. Most children recover fully, with cardiac issues resolving completely, though coronary artery involvement is rare.

Area of Science:

  • Pediatric infectious diseases
  • Pediatric critical care medicine
  • Cardiology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a significant post-infectious complication associated with COVID-19.
  • Understanding the clinical spectrum, management, and outcomes of MIS-C is crucial for pediatric healthcare providers.

Purpose of the Study:

  • To delineate the demographics, clinical characteristics, treatment strategies, and short-term outcomes of pediatric patients diagnosed with MIS-C.
  • To assess the 1-year follow-up status, particularly cardiac function, in children who experienced MIS-C.

Main Methods:

  • A retrospective observational study was conducted on 54 children meeting the World Health Organization (WHO) MIS-C criteria.
  • Data collected included patient demographics, clinical presentation, organ involvement, laboratory findings, treatment interventions, and follow-up assessments.

Main Results:

  • The study included 54 children (68.5% males, median age 5.5 years) with frequent PICU admissions (77%). Gastrointestinal (92%) and cardiovascular (85%) systems were most commonly affected. Hypotension was a frequent presenting symptom (43%).
  • All patients had elevated procalcitonin; 100% tested positive for anti-SARS-CoV-2 antibodies. Treatment involved methylprednisolone or IVIg (77%), mechanical ventilation (18.5%), and inotropic support (77%). Aspirin (48%) and LMWH (54%) were also used.
  • Hospital stay averaged 7 days, with one mortality (1.8%). Echocardiography showed complete cardiac recovery by 1-year follow-up in all patients, with coronary artery dilatation noted in only one child.

Conclusions:

  • MIS-C represents a critical complication of COVID-19 in children, often involving multiple organ systems.
  • While cardiac involvement is common during the acute phase, it demonstrates a high potential for complete resolution.
  • Coronary artery abnormalities are infrequent in MIS-C patients, and long-term cardiac outcomes are generally favorable.
Abstract

Keywords:
COVID-19IVIgKawasaki diseaseMIS-CMethylprednisolone

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