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THE EPIDEMIOLOGICAL FACTORS, CLINICAL AND LABORATORY FEATURES OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) INFECTED WITH SARS-CoV-2 AT CAN THO CHILDREN'S HOSPITAL
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Abstract
Background: Multisystem inflammatory syndrome (MIS-C) is a rare but serious medical condition that usually occurs 2–6 weeks after SARS-CoV-2 infection. MIS-C is characterized by inflammation in several organ systems including the cardiovascular, respiratory, mucosal and gastrointestinal systems and the etiology of MIS-C remains unknown. Despite the severity of MIS-C , the study of epidemiological factors, clinical and laboratory features helps to provide data and improve treatment effectiveness. Objectives: To do research on the epidemiological factors, clinical and laboratory features of Multisystem Inflammatory Syndrome in Children infected with SARS-CoV-2 (MIS - C) at Can Tho Children's Hospital. Materials and methods: This was a retrospective study of 58 patients diagnosed with MIS-C treated at Can Tho Children's Hospital (from September 2021 to September 2022). Results: A total of 58 patients were included (median age, 5,47 years old, 2 months – 13 years), 69% of cases were male, the median time from COVID-19 to onset of MIS-C-related symptoms was 6,63 weeks with average hospital stay was 11 days . All 58 patients had fever with a mean duration of fever of 7,14 days. Skin rash appeared the most with 81%, mucosal changes with strawberry tongue symptoms accounted for 34,5%, red lips with 63,8%, loose stools with 27,6%, 28/58 patients had limb edema (41,4%), neck lymph node with 8,6%, 10/58 patients had shock (17,2%). Patients with the increase in white blood cells accounted for 48,3%, the increased platelets with 10,3%, 51 patients did CRP with median value of 122,9 mg/L, Procalcitonin had 36 (97.2%) patients tested for concentration with an average value of 34,31 ng/mL, 45 patients was recorded with median Ferritin value of 411000 µ/L, mean D-dimmer value observed in 49 patients with 7,05 µg/ml, Fibrinogen was performed in 52 cases with a median value of 5,29 g/L, echocardiography in 55 patients had 13/55 cases of coronary vasodilation (22,4%) including 7 cases of left coronary artery dilation and 6 cases of dilatation of both coronary arteries. There was a significant difference in the shock condition with the level of ferritin (p=0,037) and difference between coronary artery dilation and platelet count (p=0,018), as well as the correlation between procalcitonin levels and the length of hospital stay (p=0,027). Oral or oropharyngeal findings were associated significantly with the presence of skin rash (p=0,008) and conjunctivitis (p=0,001). Conclusion: The most typical organ injury in MIS-C was mucocutaneous. Higher levels of ferritin increased the risk of shock and elevated platelet counts increased the ability to get coronary artery dilation in patients with MIS-C. Those with higher procalcitonin levels at admission were found to stay longer in the hospital. The presence of oral or oropharyngeal changes might be an early indicator of MIS-C and should be considered suggestive of MIS-C in the setting of COVID-19 infection.
Keywords: Epidemiological factors, clinical features, laboratory features, MIS-C.
Article Details
Keywords
Epidemiological factors, clinical features, laboratory features, MIS-C
References
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