ĐẶC ĐIỂM VÀ YẾU TỐ TIÊN LƯỢNG NẶNG CỦA HỘI CHỨNG VIÊM ĐA HỆ THỐNG Ở TRẺ EM (MIS-C) TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ NĂM 2021-2022

Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C) is a newly identified and serious health condition associated with SARS-CoV-2 infection. Clinical manifestational varies widely among patients with MIS-C and factors associated with severe outcomes. Objective: 1) To describe the clinical and paraclinical characteristics, treatment results in children with MIS-C. 2) To identify prognostic factors to the severity of MIS-C. Materials and methods: An analytic crosssectional study of 61 cases of MIS-C in Can Tho Children’s Hospital. Results: The median age was 45.0 (22.5-108.0) months, with a male-to-female ratio of 2:1. The median time from SARS-CoV-2 infection to MIS-C onset was 4.5 (4.0-7.5) weeks. Clinical symptoms included high fever (89.5%), gastrointestinal symptoms (75.4%), and conjunctivitis (82.5%). The number of severe cases is 16 (26.2%), with severe deterioration after 24 hours of hospital admission being 12 (19.7%). Paraclinical characteristics included CRP >10 mg/L (96.1%), fibrinogen >4.5 g/L (71.7%). All cases were cured and discharged from the hospital. Independent factors associated with the severity of disease are: abdominal pain OR=10.984 (95% CI: 1.602-75.294, p=0.015), elevated ferritin OR=4.689 (95% CI: 1.015-21.664, p=0.048), elevated D-dimer OR=7.694 (95% CI: 1.537-38.507, p=0.013), elevated troponin I OR=6.657 (95% CI: 1.124-39.431, p=0.037). Conclusion: Children with MIS-C are mainly males with a median age of 45.0 (22.5-108.0) months, common symptoms include Kawasaki-like skin lesions and gastrointestinal symptoms. Severe cases account for 26.2%, with deterioration after 24 hours of hospitalization accounting for 19.7%. Abdominal pain, elevated ferritin, elevated D-dimer, and elevated troponin-I are independent and prognostic factors for the severity of MIS-C after 24 hours of hospitalization.