Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital

Balagurunathan, Muruganantham; Natarajan, Thrilok; Karthikeyan, Jothilakshmi; Palanisamy, Venkateshwaran

doi:10.3345/cep.2021.00374

Cited by 13 publications

(10 citation statements)

References 14 publications

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“…Consistent with published data from across the globe and many Indian studies, children in our study also presented with fever, rash, gastrointestinal symptoms and shock. [4][5][6][7][8][9] The median age of children in our study was 7 years (2 months to 12 years) with 76.6% of affected children above the age of 5 years, which was similar to various studies done in Indian children. 4,[6][7][8][9][10][11] Our study had a male preponderance (60%) similar to previous reports although Dhanlakshmi et al, Jain et al and Shobhavat et al recorded a female preponderance probably due to fewer number of patients studied.…”

Section: Figure 1: Temporal Association Of Misc Cases With Covid Case...supporting

confidence: 83%

“…[4][5][6][7][8][9] The median age of children in our study was 7 years (2 months to 12 years) with 76.6% of affected children above the age of 5 years, which was similar to various studies done in Indian children. 4,[6][7][8][9][10][11] Our study had a male preponderance (60%) similar to previous reports although Dhanlakshmi et al, Jain et al and Shobhavat et al recorded a female preponderance probably due to fewer number of patients studied. [4][5][6][7][8][9]11 A low incidence of RT-PCR positivity (13%) with a high presence of SARS-CoV-2 antibodies (86.6%) was seen in our study similar to studies done in Southern and Western India while Gupta et al and Maheshwari et al reported higher RTPCR positivity rate in children with MIS-C in North India.…”

Section: Figure 1: Temporal Association Of Misc Cases With Covid Case...supporting

confidence: 83%

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Clinical, biochemical and echocardiographic characteristics in children with multisystem inflammatory syndrome associated with coronavirus disease: a tertiary care experience

D’Sa

Joshi²

2022

Int J Contemp Pediatr

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Background: We describe the clinical, biochemical and echocardiographic characteristics in children diagnosed with multisystem inflammatory syndrome (MISC) temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-Co-V-2), admitted to a tertiary care hospital in Goa, India.Methods: This was a retrospective observational study conducted at Goa Medical College, Goa, India. Parameters including demographics, clinical features, laboratory markers, medications and outcomes were obtained from patient hospital records; analyzed for patients treated for MISC (as per WHO case definition) for a period of 11 months from 01 July 2020 to 31 July 2021.Results: 30 patients (18 males) with median age of 7 years (IQR: 2 months – 12 years) were included. The proportion of children with gastrointestinal symptoms was 20 (64.5%), shock was a presenting feature in 15 (48%) and coronary ectasia and/or low ejection fraction was seen in 12 children (38.7%).Conclusions: A high index of suspicion for the diagnosis of MIS-C in children presenting with fever and Kawasaki disease like symptoms or signs of shock is recommended; since early aggressive therapy with Intravenous Immunoglobulins and methylprednisolone can have favourable outcomes.

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Section: Figure 1: Temporal Association Of Misc Cases With Covid Case...supporting

confidence: 83%

Section: Figure 1: Temporal Association Of Misc Cases With Covid Case...supporting

confidence: 83%

Clinical, biochemical and echocardiographic characteristics in children with multisystem inflammatory syndrome associated with coronavirus disease: a tertiary care experience

D’Sa

Joshi²

2022

Int J Contemp Pediatr

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“…[24][25][26][27] There are also MIS-C case reports in the literature from Africa and Asia. 28,29 Overall population incidence estimates for MIS-C range from 2 per 100,000 children in New York State to 3 per 10,000 individuals less than 21 years of age infected with SARS-CoV-2. 30,31 Incidence after a diagnosis of MIS-C is difficult to determine as so many children are asymptomatic with their initial infection thus not tested.…”

Section: Epidemiologymentioning

confidence: 99%

Severe COVID-19 and Multisystem Inflammatory Syndrome in Children in Children and Adolescents

Blatz¹,

Randolph²

2022

Critical Care Clinics

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Synopsis: Severe complications related to COVID-19 occur infrequently in children and adolescents. The two major types of life-threatening complications are acute respiratory failure from acute COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C). MIS-C is a post-infectious complication occurring approximately 3-6 weeks after an asymptomatic or mild SARS-CoV-2 infection. For both types of complications, supportive ICU care is provided. For MIS-C critical illness, immunomodulation is prescribed to reverse hyperinflammation and its cardiac and other sequelae.

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“…Biomarkers of cardiac dysfunction, troponin and pro-Brain natriuretic peptide (pro-BNP) were also reported to be deranged in many studies [5][6][7]. Around 82% of affected children had high pro-BNP values (median (range) 8202 (202-29562) pg/mL), while 34% reported high troponin values (median value (range) 81 (33-348) pg/mL).…”

Section: Laboratory Parametersmentioning

confidence: 99%

“…Inotropic and vasoactive support was given to 49% patients. Four studies [5,7,9,10] used anti-coagulative drugs such as heparin and aspirin in 69% of patients. Not all studies have reported the use of antibiotics, but where needed, it was given to around 90% of the cases.…”

Section: Managementmentioning

confidence: 99%

Multisystem Inflammatory Syndrome Associated With COVID-19 in Children (MIS-C): A Systematic Review of Studies From India

et al. 2022

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Background With wide clinical spectrum, multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) in children (MIS-C) is a relatively novel condition occurring weeks to months’ post SARS-CoV-2 infection. The aim was to systematically review data on clinical features, laboratory parameters and therapeutics of MIS-C from India. Methods This systematic review was done as per the PRISMA guidelines, and quality assessment was done using NIH tool for case-series. A systematic search through databases yielded studies whose data was pooled to calculate the mean frequencies with standard deviation using GraphPad software. Results Screening of 2548 articles published till December, 2021, yielded 11 case-series. World Health Organization case definition was used widely. There was a slight preponderance of males (57%), median (IQR) age was 7 (6,7) years, 63% ( n =305) required intensive care unit admissions, and mortality rate was 10% ( n =261). Clinical features included fever, mucocutaneous features (72%), and gastrointestinal problems (62%) in majority. Widely used treatment was corticosteroids (76%) and intravenous immunoglobulin (62%) with other options depending on patient’s state. An increased level of inflammatory markers and derangement in other parameters corroborated with disease status. Kawasaki disease like features, not reported in many studies, ranged from 4-76% of patients. Conclusion MIS-C presents with a wide spectrum clinical features, increased inflammatory markers and managed as per the disease course and presentation. Future studies monitoring the long-term effects of MIS-C are recommended.

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Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital

Abstract: Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital

Cited by 13 publications

References 14 publications

Clinical, biochemical and echocardiographic characteristics in children with multisystem inflammatory syndrome associated with coronavirus disease: a tertiary care experience

Clinical, biochemical and echocardiographic characteristics in children with multisystem inflammatory syndrome associated with coronavirus disease: a tertiary care experience

Severe COVID-19 and Multisystem Inflammatory Syndrome in Children in Children and Adolescents

Multisystem Inflammatory Syndrome Associated With COVID-19 in Children (MIS-C): A Systematic Review of Studies From India

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