No abstract

We report herein a case series of infants, with no comorbidities, who developed a life‐threatening illness due to the SARS‐CoV‐2 Delta variant. We retrospectively reviewed the medical records of children, aged under 15 years, admitted to PICU, during the peak of Delta infection, between June 23 and August 16 2021, with severe and critical forms of SARS‐CoV‐2 infection, confirmed by RT‐PCR. Twenty infants were included, the median age was 47 days (IQR: 26.5–77) and sex ratio was 0.8. No underlying medical conditions were noted. Parents were not vaccinated. Respiratory involvement was the main feature observed. Eleven patients had paediatric acute respiratory distress (PARDS) with a median oxygen saturation index (OSI) of 9 (IQR: 7–11). PARDS was mild in four, moderate in five, and severe in two cases. Hemodynamic instability was observed in 4 cases. The main radiological finding was ground glass opacities in 11 cases. Seventeen patients were mechanically ventilated, and three of them were escalated to high‐frequency oscillatory ventilation. The median duration of mechanical ventilation was 6 days (IQR 2.5–12.5). The remaining patients were managed with high‐flow nasal cannula. Four patients died.

BACKGROUND AND AIM: Multisystem inflammatory syndrome in children (MIS-C) is a new serious emerging disease related to previous exposure to coronavirus infection disease . AIM:To describe the clinical features, laboratory findings, therapies, and outcomes of children with MIS-C in a Tunisian PICU. METHOD:Prospective study conducted between 01 November and 30 December 2021. Patients aged less than 15 years, admitted to our PICU, and met the criteria for MIS-C according to the WHO definition case, were included. Demographic and clinical data, laboratory test results, echocardiographic findings, treatment, and outcomes were collected during hospitalization. RESULTS:The median age was 9 years (IQR: 5-10). Obesity was noted in 1 patient. Ten patients were boys. Median delay between symptom and PICU admission was 6days (IQR:5-7). Fever and gastrointestinal symptoms were reported in all cases. Five patients had marked abdominal pain and were examined by the surgeon for a possible appendicitis. Cardiac dysfunction was reported in 13 cases with a median LVEF 42% (IQR: 33-50). Two patients had a vasoplegic shock and needed norepinephrine. Median CRP was 281mg/l (166-347). Median lymphocyte count was 880cells /mm3(520-1270). Median D-Dimers was 4631 ng/ ml (1582-8672). Median troponin was 339ng/L (IQR: 36 879). Median pro BNP was 9199pg/ml (2825-25000). All patients had positive SARS-COV-2 serology. Only 4 patients required mechanical ventilation. All patients received inotropes, immunoglobulins, methyl prednisolone and a low dose of aspirin. One patient died. CONCLUSIONS:We report herein clinical features, management, and outcomes of critically ill children with MIS-C to highlight the severity of clinical presentation with a good prognosis.