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DOI: 10.1055/s-0041-1733943
Multisystem Inflammatory Syndrome in Children Admitted to a Tertiary Pediatric Intensive Care Unit
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C) is characterized by persistent fever, abdominal pain, vomiting, diarrhea, rash, conjunctivitis, headaches, and mucocutaneous manifestations and it can cause circulatory dysfunction, resulting in hypotension, shock, and end-organ injury in the heart and other organs and possibly death. In this study, we aimed to analyze the clinical spectrum, treatment options and outcomes of children with MIS-C who were admitted to our pediatric intensive care (PICU).
Materials and Methods Clinical and laboratory findings and treatment of the patients admitted to the PICU with MIS-C between April 2020 and January 2021 were recorded, and their outcomes were evaluated.
Results Nineteen patients with a median age of 12.5 years (interquartile range (IQR): 5.8–14.0 years) were admitted. Eleven (57.8%) were males. The most frequent clinical and laboratory features were fever (100%), abdominal pain (94.7%), rash (63.1%), headache (68.4%), diarrhea (47.3%), seizure (10.5%), cardiac dysfunction (52.6%), acute kidney injury (26.3%), lymphopenia (84.2%), and thrombocytopenia (36.8%). However, 8 patients needed mechanical respiratory support, 11 patients needed inotropes, 2 patients needed plasma exchange, and 1 patient needed continuous renal replacement therapy. All patients received corticosteroids, 17 patients (89.2%) received intravenous immunoglobulin, 2 patients received anakinra, 10 patients received acetylsalicylic acid, and 6 patients received enoxaparin. Median PICU length of stay was 3 days (IQR: 2–5) and only one patient died.
Conclusion In conclusion, MIS-C may present with a variety of clinical manifestations, and it can lead to life-threatening critical illness. Most children need intensive care and the response to immunomodulation is usually favorable.
Keywords
multisystem inflammatory syndrome in children - COVID-19 - children - pediatric intensive careNote
Ethics committee approval was obtained.
Authors' Contributions
T.K., M.G.R., S.K., E.B., B.B., A.G., A.G.G., E.G., and G.A. involved in the conception and design of the study, or acquisition of data, or analysis and interpretation of data. E.C., E.T., T.U., T.K., and E.G. dedicated to the drafting the article or revising it critically for important intellectual content. E.C., E.T., T.U., T.K., H.O., and E.G. supported in the final approval of the version to be submitted.
Publication History
Received: 01 April 2021
Accepted: 06 July 2021
Article published online:
11 August 2021
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