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Epidemiology, clinical characteristics and outcomes of multisystem inflammatory syndrome in children
David Chun-Ern Ng1, Chuin-Hen Liew2, Kah Kee Tan3
1Hospital Tuanku Ja'afar, Seremban, Negeri Sembilan, Malaysia.
Insights
Multisystem inflammatory syndrome in children (MIS-C) in Malaysia shows age-based variations in presentation. While many children required pediatric intensive care, outcomes were favorable with no reported deaths.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious post-infectious complication.
- Understanding MIS-C epidemiology and clinical features is crucial for timely diagnosis and management.
Purpose of the Study:
- To describe the epidemiology, clinical characteristics, and outcomes of MIS-C in children from Negeri Sembilan, Malaysia.
- To investigate age-based variations in MIS-C presentation.
Main Methods:
- Retrospective, multicentre, observational study of children hospitalized with MIS-C (≤15 years) from January 2021 to June 2023.
- Incidence calculated using SARS-CoV-2 cases and census data.
- Descriptive analyses of clinical presentation and outcomes.
Main Results:
- 53 patients (median age 5.7 years, 75.5% male) were included.
- MIS-C incidence was ~5.9 cases per 1,000,000 person-months.
- Children aged 6-12 years had higher odds of cardiac dysfunction/shock, while younger children (<6 years) were more likely to show a Kawasaki disease phenotype. 41.5% required PICU admission; no mortalities occurred.
Conclusions:
- MIS-C presentation varies significantly with age.
- MIS-C can present with single-organ involvement, not exclusively multi-organ.
- Despite high PICU admission rates, MIS-C has a favorable prognosis in this cohort.
Background:
We describe the epidemiology, clinical characteristics, and outcomes of multisystem inflammatory syndrome in children (MIS-C) among children from Negeri Sembilan, Malaysia.
Methods:
A retrospective, multicentre, observational study was performed among children ≤15 years old who were hospitalized for MIS-C between January 18, 2021 and June 30, 2023. The incidence of MIS-C was estimated using reported SARS-CoV-2 cases and census population data. Descriptive analyses were used to summarize the clinical presentation and outcomes.
Results:
The study included 53 patients with a median age of 5.7 years (IQR 1.8-8.7 years); 75.5% were males. The overall incidence of MIS-C was approximately 5.9 cases per 1,000,000 person-months. Pediatric intensive care unit (PICU) admission was required for 22 (41.5%) patients. No mortalities were recorded. Children aged 6-12 years were more likely to present with cardiac dysfunction/shock (odds ratio [OR] 5.43, 95% confidence interval [CI] 1.67-17.66), whereas children below 6 years were more likely to present with a Kawasaki disease phenotype (OR 5.50, 95% CI 1.33-22.75). Twenty patients (37.7%) presented with involvement of at least four organ systems, but four patients (7.5%) demonstrated single-organ system involvement.
Conclusion:
An age-based variation in the clinical presentation of MIS-C was demonstrated. Our findings suggest MIS-C could manifest in a spectrum, including single-organ involvement. Despite the high requirement for PICU admission, the prognosis of MIS-C was favorable, with no recorded mortalities.
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