Multisystem Inflammatory Syndrome in Children: Follow-Up of a Cohort from North India.

Autor: Awasthi P; Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Chandigarh, India., Kumar V; Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Chandigarh, India., Naganur S; Department of Cardiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India., Nallasamy K; Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Chandigarh, India., Angurana SK; Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Chandigarh, India., Bansal A; Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Chandigarh, India., Manoj RK; Department of Cardiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India., Jayashree M; Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Chandigarh, India.
Jazyk: angličtina
Zdroj: The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2022 Feb 16; Vol. 106 (4), pp. 1108-1112. Date of Electronic Publication: 2022 Feb 16 (Print Publication: 2022).
DOI: 10.4269/ajtmh.21-0801
Abstrakt: Multisystem inflammatory syndrome in children (MIC-S) is a hyperinflammatory manifestation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Information on the long-term outcome of MIS-C is limited. This study was conducted to describe the long-term outcome of MIS-C from a tertiary care center in North India. Children admitted with MIS-C from September 2020 to January 2021 were followed up after discharge until June 2021. The details during the acute phase (clinical features, investigations, treatment, and outcome) and follow-up (symptoms, echocardiographic findings, ongoing treatment, and outcome) were collected retrospectively. During the acute phase, 40 children presented at median (interquartile range [IQR]) age of 7 (5-10) years with fever, mucocutaneous, gastrointestinal, and respiratory symptoms. The majority (66.7%) of the children had positive SARS-CoV-2 serology and elevated inflammatory markers (C-reactive protein, procalcitonin, ferritin, D-dimer, and fibrinogen), lymphopenia, and thrombocytopenia. Eighty percent had shock, 72.5% had myocardial dysfunction (left ventricular ejection fraction <55%), and 22.5% had coronary artery dilatation or aneurysm. Treatment included pediatric intensive care unit admission (85%), intravenous immunoglobulin (100%), steroids (85%), aspirin (80%), vasoactive drugs (72.5%), and invasive mechanical ventilation (22.5%). Two (5%) children died because of refractory shock. Thirty-four children were followed up with until a median (IQR) of 5 (3-6) months. During the follow-up, a majority were asymptomatic, myocardial function returned to normal in all, and only one had coronary artery aneurysm. Prednisolone and aspirin were given for a median (IQR) of 3 (2-4) weeks and 4 (4-6) weeks after discharge, respectively. There was one readmission and no death during the follow-up. To conclude, the long-term outcome of MIS-C is generally favorable with resolution of cardiovascular manifestations (myocardial dysfunction and coronary artery changes) in the majority of children during follow-up.
Databáze: MEDLINE