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August 11, 2021Journal of Pediatric Intensive Care1 citationsOpen Access

Multisystem Inflammatory Syndrome in Children Admitted to a Tertiary Pediatric Intensive Care Unit

EGEmrah GünTKTanıl KendirliEBEdin Botan

Key Result

Among 19 children admitted to the PICU with MIS-C, the condition frequently presented with shock and cardiac dysfunction, but 94.7% of patients survived to discharge following immunomodulatory therapy.

Study Design

Type

Cohort (n=19)

Multicenter

No

Structured PICO

P
Population
19 children and adolescents (median age 12.5 years, 42.2% female) with MIS-C admitted to a tertiary pediatric intensive care unit in Turkey.
E
Exposure
Immunomodulatory and supportive therapies including corticosteroids (100%), intravenous immunoglobulin (89.4%), anakinra (10.5%), acetylsalicylic acid (52.6%), enoxaparin (31.5%), and inotropes (57.8%).
O
Outcome
Clinical spectrum, treatment options, and outcomes (including PICU length of stay and mortality)

MIS-C can lead to life-threatening critical illness requiring intensive care, but most children respond favorably to immunomodulation with low mortality.

Limitations

  • Retrospective design
  • Small sample size
  • Different treatments applied before protocol development
  • Limited data on long-term outcomes
  • Lack of long-term outcome data

Abstract

Abstract Background Multisystem inflammatory syndrome in children (MIS-C) is characterized by persistent fever, abdominal pain, vomiting, diarrhea, rash, conjunctivitis, headaches, and mucocutaneous manifestations and it can cause circulatory dysfunction, resulting in hypotension, shock, and end-organ injury in the heart and other organs and possibly death. In this study, we aimed to analyze the clinical spectrum, treatment options and outcomes of children with MIS-C who were admitted to our pediatric intensive care (PICU). Materials and Methods Clinical and laboratory findings and treatment of the patients admitted to the PICU with MIS-C between April 2020 and January 2021 were recorded, and their outcomes were evaluated. Results Nineteen patients with a median age of 12.5 years (interquartile range (IQR): 5.8–14.0 years) were admitted. Eleven (57.8%) were males. The most frequent clinical and laboratory features were fever (100%), abdominal pain (94.7%), rash (63.1%), headache (68.4%), diarrhea (47.3%), seizure (10.5%), cardiac dysfunction (52.6%), acute kidney injury (26.3%), lymphopenia (84.2%), and thrombocytopenia (36.8%). However, 8 patients needed mechanical respiratory support, 11 patients needed inotropes, 2 patients needed plasma exchange, and 1 patient needed continuous renal replacement therapy. All patients received corticosteroids, 17 patients (89.2%) received intravenous immunoglobulin, 2 patients received anakinra, 10 patients received acetylsalicylic acid, and 6 patients received enoxaparin. Median PICU length of stay was 3 days (IQR: 2–5) and only one patient died. Conclusion In conclusion, MIS-C may present with a variety of clinical manifestations, and it can lead to life-threatening critical illness. Most children need intensive care and the response to immunomodulation is usually favorable.

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Cite This Study

Gün et al. (2021) conducted a cohort in Multisystem Inflammatory Syndrome in Children (MIS-C) (n=19). Multisystem Inflammatory Syndrome in Children (MIS-C) was evaluated on Survival to PICU discharge. Among 19 children admitted to the PICU with MIS-C, the condition frequently presented with shock and cardiac dysfunction, but 94.7% of patients survived to discharge following immunomodulatory therapy.

synapsesocial.com/papers/6a734c0f1641e80ff1c677c4https://doi.org/10.1055/s-0041-1733943
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