Multisystem Inflammatory Syndrome in Children (MIS-C) temporally related to COVID-19: the experience at a pediatric reference hospital in Colombia.

Autor: Lozano-Espinosa DA; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., Camacho-Moreno G; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia.; Universidad Nacional de Colombia, Bogotá, Colombia., López-Cubillos JF; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., Díaz-Maldonado AS; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., León-Guerra OJ; Hospital Cardiovascular de Cundinamarca, Bogotá, Colombia., Galvis-Trujillo DM; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., Sanguino-Lobo R; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., Arévalo-Leal OG; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., Del Castillo AME; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., Reina-Ávila MF; Fundación Hospital Pediátrico La Misericordia, Bogotá, Colombia., Cárdenas-Hernández VC; Universidad Nacional de Colombia, Bogotá, Colombia., Ivankovich-Escoto G; Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', San José, Costa Rica., Tremoulet AH; University of California San Diego, Kawasaki Disease Research Center, San Diego, CA, United States., Ulloa-Gutiérrez R; Hospital Nacional de Niños 'Dr. Carlos Sáenz Herrera', San José, Costa Rica.
Jazyk: angličtina
Zdroj: Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo [Rev Paul Pediatr] 2022 Nov 14; Vol. 41, pp. e2021267. Date of Electronic Publication: 2022 Nov 14 (Print Publication: 2022).
DOI: 10.1590/1984-0462/2023/41/2021267
Abstrakt: Objective: This study aimed to describe the clinical characteristics and the different phenotypes of children with multisystem inflammatory syndrome in children (MIS-C) temporally related to COVID-19 and to evaluate the risk conditions that favored a greater severity of the disease during a 12-month period at a pediatric reference hospital in Colombia.
Methods: A 12-month retrospective observational study of children under the age of 18 years who met criteria for MIS-C.
Results: A total of 28 children presented MIS-C criteria. The median age was 7 years. Other than fever (100%) (onset 4 days prior to admission), the most frequent clinical features were gastrointestinal (86%) and mucocutaneous (61%). Notably, 14 (50%) children had Kawasaki-like symptoms. The most frequent echocardiographic abnormalities were pericardial effusion (64%), valvular involvement (68%), ventricular dysfunction (39%), and coronary artery abnormalities (29%). In addition, 75% had lymphopenia. All had at least one abnormal coagulation test. Most received intravenous immunoglobulin (89%), glucocorticoids (82%), vasopressors (54%), and antibiotics (64%). Notably, 61% had a more severe form of the disease and were admitted to an intensive care unit (median 4 days, mean 6 days); the severity predictors were patients with the inflammatory/MIS-C phenotype (OR 26.5; 95%CI 1.40-503.7; p=0.029) and rash (OR 14.7; 95%CI 1.2-178.7; p=0.034). Two patients had macrophage activation syndrome.
Conclusions: Coronary artery abnormalities, ventricular dysfunction, and intensive care unit admission were frequent, which needs to highlight the importance of early clinical suspicion.
Databáze: MEDLINE
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