Risk factors for haemodynamic compromise in multisystem inflammatory syndrome in children: a multicentre...

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Pediatric rheumatology

Background:

• Multisystem inflammatory syndrome in children (MIS-C) is a serious post-infectious complication.
• Identifying predictors of severe MIS-C is crucial for timely intervention.

Purpose of the Study:

• To identify clinical and laboratory predictors of severe multisystem inflammatory syndrome in children (MIS-C).
• To define severe MIS-C by the need for inotropic support.

Main Methods:

• Retrospective study of 100 MIS-C patients across 10 medical centers (July 2020-March 2021).
• Univariate and multivariate regression analyses assessed demographic, clinical, laboratory, and imaging variables.
• Odds ratios (OR) were calculated for severe disease predictors.

Main Results:

• Left ventricular dysfunction (OR 4.178) predicted severe MIS-C.
• Conjunctivitis (OR 0.403) and mucosal changes (OR 0.333) at admission were protective.
• Central nervous system involvement and fever >39.5°C were associated with severe disease in multivariate analysis.
• Low hemoglobin/platelets and elevated troponin were risk factors; mucosal involvement reduced risk by 6.2-fold.

Conclusions:

• Clinical and laboratory parameters during the disease course, not just at admission, predict severe MIS-C.
• Early identification of risk factors can guide closer monitoring and prompt treatment.
• Patients with Kawasaki-like features had a lower likelihood of requiring inotropic support.