Critical cases of MIS-C frequently presented with cardiac conditions, most commonly valvulitis, and had a 13.3% mortality rate that was significantly correlated with underlying comorbidities.
Observational (n=45)
No
In children with critical MIS-C, cardiac involvement is prominent and most commonly presents as valvulitis, with mortality strongly associated with underlying comorbidities.
Abstract Objective Multisystem inflammatory syndrome in children (MIS-C) is a critical childhood disease that is associated with coronavirus disease (COVID-19). We aimed to describe the clinical, laboratory, and echocardiographic characteristics and outcome of critical MIS-C cases in Egyptian children during the first wave of the COVID-19 pandemic. Design A retrospective, observational study. Setting A single-center tertiary pediatric intensive care unit (PICU).In Ain Shams university hospitals Cairo Egypt Methods Children admitted to the PICU diagnosed with severe MIS-C as per the Centers for Disease Control’s definition from June 23, 2020, to August 22, 2020, were included. Results The patient’s mean age was 7.45 (interquartile range IQR, 4.23) years, and the cause of PICU admission was hypotension and shock. All patients had a fever for 4.8 (IQR, 2.5) days before shock developed. Overall, 68% had a gastrointestinal manifestation, and 55.6% had a rash. Thirty-five of 45 patients had ≥ 4 elevated inflammatory markers. The cardiac troponin I level was elevated in 35 of 45 patients. The most common cardiac condition was valvulitis (tricuspid regurgitation, 29/45; mitral valve regurgitation, 28/45; pulmonary valve regurgitation, 5/45; atrial valve regurgitation, 4/45). Twenty-one patients had an impaired ejection fraction < 50%, and 17 patients had coronary dilatation. Six patients had pericardial effusion, 1 patient had dilated pulmonary arteries, and 6 patients (13.3%) died of their associated comorbidities. The mean PICU length of stay among patients with no associated comorbidities was 7 days. Conclusions Critical cases of MIS-C had a spectrum of different cardiac conditions, with valvulitis being the most common one. The worst outcome occurred in patients with comorbidities and infants.
Ibrahim et al. (2024) conducted an observational in Critical multisystem inflammatory syndrome in children (MIS-C) (n=45). Critical multisystem inflammatory syndrome in children (MIS-C) was evaluated on Mortality. Critical cases of MIS-C frequently presented with cardiac conditions, most commonly valvulitis, and had a 13.3% mortality rate that was significantly correlated with underlying comorbidities.