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Incidence, Clinical Profile, and Cardiac Manifestations of MIS-C in Children in Kuwait
Ozayr Mahomed1,2, Adnan Alhadlaq3,4, Khaled Alsaeid5
1Department of Population Health, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait.
Insights
Multisystem inflammatory syndrome in children (MIS-C) in Kuwait affects younger children post-SARS-CoV-2 infection. While most recover, cardiac issues like coronary abnormalities are significant concerns requiring further study.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a rare post-SARS-CoV-2 hyperinflammatory condition.
- Coronary artery aneurysms are the most common long-term sequelae.
- MIS-C presentation varies globally.
Purpose of the Study:
- To describe the epidemiology, clinical features, cardiac manifestations, treatment, and outcomes of MIS-C in Kuwaiti children (under 14) infected with SARS-CoV-2.
- To analyze data from February 2020 to November 2021.
Main Methods:
- Retrieved data from the Pediatric COVID registry (PCR-Q8).
- Analyzed sociodemographic factors, co-morbidities, clinical signs, symptoms, laboratory results, and echocardiography findings.
- Included 83 patients meeting WHO criteria for MIS-C.
Main Results:
- Eighty-three of 102 suspected cases met WHO MIS-C criteria.
- Sixteen MIS-C patients had cardiac abnormalities, including coronary abnormalities (63%), myocardial dysfunction (56%), and pericarditis (19%).
- One death occurred due to cardiogenic shock; 39 patients required ICU admission.
Conclusions:
- MIS-C in Kuwait affects younger children compared to other regions, but clinical patterns are similar.
- Cardiac sequelae, particularly coronary abnormalities, are prevalent.
- Further analytical studies are needed to identify risk factors for MIS-C and its cardiac complications.
Abstract:
Background/Objectives: Multisystem inflammatory syndrome in children (MIS-C), a rare but serious post-acute hyperinflammatory condition that occurs in children 2-6 weeks after Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection or exposure, varies between countries. Despite its serious nature, most children recover without any sequelae. The most frequently reported long-term sequelae are coronary artery aneurysms. This study aimed to describe the epidemiological profile, clinical characteristics (including cardiac manifestations), treatment, and outcomes of multisystem inflammatory syndrome in children (MIS-C) under 14 years of age with SARS-CoV-2 between February 2020 and November 2021 in Kuwait. Methods: Data on sociodemographic factors, co-morbidities, presenting signs and symptoms, as well as laboratory and echocardiography findings were retrieved from the Pediatric COVID registry (PCR-Q8 registry). Results: Of the one hundred and two patients with a provisional diagnosis of MIS-C, eighty-three patients fulfilled the WHO criteria of MIS-C. Thirty-nine of the MIS-C patients were admitted to the intensive care unit, and only one child died due to cardiogenic shock. Sixteen patients from the pediatric MIS-C cohort were diagnosed with cardiac abnormalities. Sixteen patients from the pediatric MIS-C cohort were diagnosed with cardiac abnormalities. Most (63% (10/16)) of the patients had coronary abnormalities, nine patients (56%) had myocardial dysfunction, and six patients (38%) had dual pathologies. Pericarditis occurred in three patients only, whilst six patients (38%) had dual pathologies. Pericarditis occurred in three patients only. Conclusions: MIS-C appears to affect younger children in Kuwait than in other countries; however, the clinical pattern is consistent with other countries. Further studies of an analytical nature are recommended to identify the risk factors associated with MIS-C and its cardiac sequalae to allow for proactive risk reduction.
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