Low ICU Admission and Excellent Outcomes in MIS-C: A Swedish Study From an Open Society

During the COVID-19 pandemic, Sweden chose a more open public health approach. A general concern was that this approach would affect the population negatively. We describe the Swedish national MIS-C cohort and risk factors for severe disease defined as admission to the intensive care unit and cardiogenic shock.

Nationwide population-based cross-sectional study. All children and adolescents from 0 to 19 years of age with MIS-C from March 2020 to August 2022 were included. Multivariable logistic regression with ICU admission and cardiogenic shock as outcomes was used to evaluate risk factors for severe disease.

A total of 338 MIS-C cases were identified; 69 patients (20%) required intensive care and 38 patients (11%) developed cardiogenic shock. Clinical findings associated with ICU admission were cardiac involvement: OR 14.00 (6.28-34.70), airway involvement: OR 6.75 (3.23-14.80), hyperinflammation: OR 3.25 (1.34-7.97), oedema: OR 2.40 (1.07-5.44) and diarrhoea: OR 2.23 (1.07-4.80). Clinical findings associated with cardiogenic shock were hyperinflammation: OR 5.10 (2.16-12.00), airway involvement: OR 4.87 (2.12-12.00), higher age (13-19 vs. 0-5 years): OR 3.85 (1.17-15.60), obesity: OR 3.55 (1.14-10.5) and diarrhoea: OR 2.48 (1.09-5.92).

In Swedish national MIS-C cohort, the rate of ICU admission was low and outcome excellent. Identifying risk factors for ICU admission and cardiogenic shock may facilitate early detection of risk patients.