The clinical features and estimated incidence of MIS-C in Cape Town, South Africa.

Autor: Butters C; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; Institute of Infectious Disease and Molecular Medicine (IDM), Department of Pathology, Division of Immunology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa., Abraham DR; Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa., Stander R; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Facey-Thomas H; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Abrahams D; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Faleye A; Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria., Allie N; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Soni K; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Rabie H; Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa., Scott C; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Zühlke L; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.; Faculty of Health Sciences, Cape Heart Institute (CHI), University of Cape Town, Cape Town, South Africa., Webb K; Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. kate.webb@uct.ac.za.; Crick African Network, Francis Crick Institute, London, UK. kate.webb@uct.ac.za.
Jazyk: angličtina
Zdroj: BMC pediatrics [BMC Pediatr] 2022 May 02; Vol. 22 (1), pp. 241. Date of Electronic Publication: 2022 May 02.
DOI: 10.1186/s12887-022-03308-z
Abstrakt: Background: Multisystem inflammatory syndrome is a severe manifestation of SARS-CoV-2 in children. The incidence of MIS-C after infection is poorly understood. There are very few cohorts describing MIS-C in Africa despite MIS-C being more common in Black children worldwide.
Methods: A cohort of children with MIS-C and healthy children was recruited from May 2020 until May 2021 from the two main paediatric hospitals in Cape Town, South Africa. Clinical and demographic data were collected, and serum was tested for SARS-CoV-2 antibodies. The incidence of MIS-C was calculated using an estimation of population exposure from seroprevalence in the healthy group. Summary data, non-parametric comparisons and logistic regression analyses were performed.
Results: Sixty eight children with MIS-C were recruited with a median age of 7 years (3.6, 9.9). Ninety seven healthy children were recruited with a 30% seroprevalence. The estimated incidence of MIS-C was 22/100 000 exposures in the city in this time. Black children were over-represented in the MIS-C group (62% vs 37%, p = 0.002). The most common clinical features in MIS-C were fever (100%), tachycardia (98.5%), rash (85.3%), conjunctivitis (77.9%), abdominal pain (60.3%) and hypotension (60.3%). The median haemoglobin, sodium, neutrophil count, white cell count, CRP, ferritin, cardiac (pro-BNP, trop-T) and coagulation markers (D-dimer and fibrinogen) were markedly deranged in MIS-C. Cardiac, pulmonary, central nervous and renal organ systems were involved in 71%, 29.4%, 27.9% and 27.9% respectively. Ninety four percent received intravenous immune globulin, 64.7% received methylprednisolone and 61.7% received both. Forty percent required ICU admission, 38.2% required inotropic support, 38.2% required oxygen therapy, 11.8% required invasive ventilation and 6% required peritoneal dialysis. Older age was an independent predictor for the requirement for ionotropic support (OR = 1.523, CI 1.074, 2.16, p = 0.018). The median hospital stay duration was 7 days with no deaths.
Conclusion: The lack of reports from Southern Africa does not reflect a lack of cases of MIS-C. MIS-C poses a significant burden to children in the region as long as the pandemic continues. MIS-C disproportionately affects black children. The clinical manifestations and outcomes of MIS-C in this region highlight the need for improved surveillance, reporting and data to inform diagnosis and treatment.
(© 2022. The Author(s).)
Databáze: MEDLINE
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