Multisystem Inflammatory Syndrome in Children (MIS-C): The Overlooked Role of Gastrointestinal Symptoms

Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that involves multiple organs, including the gastrointestinal (GI) tract. Recognizing GI symptoms can aid in early diagnosis and management. Objectives: The present study aimed to evaluate the prevalence and types of GI symptoms in children with MIS-C hospitalized at Bandar Abbas Children’s Hospital from 2020 to 2022. Methods: This descriptive cross-sectional study analyzed 209 pediatric MIS-C cases. Data, including demographic, clinical, and laboratory findings, were extracted from hospital records and analyzed using SPSS software. Results: Of the children studied, 56.9% were male. The most common GI symptoms were vomiting (23.0%) and diarrhea (21.1%). Multivariable analysis identified male gender as a significant independent predictor of vomiting [adjusted odds ratio (aOR) = 2.45, 95% confidence interval (CI): 1.35 - 4.44], and age < 5 years was also associated with higher odds of vomiting (aOR = 1.85, 95% CI: 1.02 - 3.35). Diarrhea was also significantly more prevalent in males (70.5% of all diarrhea cases; P = 0.03). The most common laboratory abnormality was elevated liver enzymes (49.3%). Conclusions: The GI symptoms play a significant role in MIS-C presentations. Early recognition, particularly of liver enzyme abnormalities, vomiting, and diarrhea, is crucial for timely management.