Characteristics and outcomes of cases of children and adolescents with pediatric inflammatory multisystem syndrome in a tertiary care center in Mexico City

Abstract

Background: pediatric inflammatory multisystem syndrome (PIMS) is a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children that resembles Kawasaki syndrome and poses children at high risk of cardiorespiratory instability and/or cardiac damage. This study aims to describe the clinical presentation and outcomes of patients with PIMS in Mexico City. Methods: this was an observational study (May 1, 2020, to September 30, 2021) of children with PIMS according to Centers of Disease Control and Prevention case definition criteria, hospitalized in a single tertiary care pediatric center in Mexico City. Demographic characteristics, epidemiological data, medical history, laboratory tests, cardiology evaluations, treatment, and clinical outcomes were analyzed. Results: Seventy-five cases fulfilled case-definition criteria for PIMS (median age 10.9 years, IQR: 5.6-15.6). Fifteen (20%) had a severe underlying disease. Forty-eight cases (64%) were admitted to the intensive care unit, 33 (44%) patients required invasive mechanical ventilation, and 39 (52%) received vasopressor support. Two distinct groups of patients were identified: cluster 1 (n=60) who had rash or gastrointestinal symptoms and cluster 2 (n=15) with predominantly respiratory manifestations. Two cases (2.7%) died, both with severe underlying conditions. Five cases (6.7%) developed coronary aneurysms, all of them from cluster 1. Conclusion: clinical manifestations and outcomes are in general comparable what has been previously reported in international series. In our series, there was a high proportion of patients with severe respiratory involvement and positive RT-PCR SARS-CoV-2 and a low frequency of coronary aneurysms which suggests a possible higher proportion of children with severe acute COVID-19 in our included cases.

A Research Study on Prompt Results and Physical Assessment of Mechanically Ventilated Children

“…However, some studies discovered that neurological disease was the most frequent cause of MV in their PICUs. [18][19][20][21] The most plausible reason for these discrepancies is that the causes of PICU admissions vary by country and rely on the diseases that are common in that area. Children in PICUs who are mechanically ventilated often have complications.…”