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Multisystem Inflammatory Syndrome in Children (MIS-C) Post COVID-19 Infection: Diagnosis and Treatment from the
Sayed H Almosawi1, Amreen Mustafa1, Fareedul A Hassan2
1School of Medicine, Royal College of Surgeons in Ireland, Manama, BHR.
Insights
Multisystem Inflammatory Syndrome in Children (MIS-C) following COVID-19 infection presents with diverse symptoms. While both IVIG and combination therapy improved outcomes, combination therapy showed a trend toward better results in pediatric intensive care unit patients.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Rheumatology
Background:
- Children infected with SARS-CoV-2 can develop Multisystem Inflammatory Syndrome in Children (MIS-C).
- MIS-C presents with varied clinical features, affecting multiple organ systems.
- Gastrointestinal and ophthalmological symptoms are common in MIS-C.
Purpose of the Study:
- To describe clinical manifestations of MIS-C in children admitted to the pediatric intensive care unit (PICU).
- To evaluate the impact of different treatment strategies on patient outcomes.
Main Methods:
- Retrospective cross-sectional study of 11 MIS-C patients.
- Patients were classified using World Health Organization (WHO) criteria.
- Treatment involved intravenous immunoglobulin (IVIG) with or without corticosteroids.
Main Results:
- The study included 6 females and 5 males, with an average age of 5.08 years.
- Ten patients had confirmed SARS-CoV-2 infection; one had contact history.
- All patients exhibited fever and elevated inflammatory markers; clinical and inflammatory markers improved significantly post-treatment.
Conclusions:
- Both IVIG and combination therapy (IVIG plus corticosteroids) led to significant clinical improvement.
- Combination therapy suggested improved outcomes, though not statistically significant compared to IVIG alone.
Background:
Post coronavirus disease 2019 (COVID-19) infections, children presented with varying clinical manifestations of a Multisystem Inflammatory Syndrome in Children (MIS-C). The aim of our study is to identify the clinical manifestations upon admission to paediatric intensive care unit (PICU) and to identify how different treatments affected post-treatment outcomes. Methods: A retrospective cross-sectional study included 11 patients diagnosed with multisystem inflammatory syndrome based on the World Health Organization (WHO) classification and treated by intravenous immunoglobulin (IVIG) with/without corticosteroids. Results: There were six female and five male patients with an average age of 5.08±4.7 years. Ten had a confirmed positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological antibody test or polymerase chain reaction (PCR) test, with one having only contact history. The most common systems affected by MIS-C were gastrointestinal and ophthalmological presentations. All presented with fever and raised inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, procalcitonin, ferritin, d-dimer, and lactate dehydrogenase). There was no statistical difference between both treatment groups. Clinical and inflammatory markers significantly improved in both groups.
Conclusion:
This study highlights an improved outcome associated with combination therapy, although there is no statistical significance between both groups.
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