Clinical profile and outcome of patients admitted as multisystem inflammatory syndrome in children in a paediatric tertiary care hospital of North India

Abstract

Background: Severe acute respiratory syndrome corona virus‑2 (SARS‑CoV‑2) infection can lead to multisystem inflammatory syndrome in children (MIS‑C). This study was conducted to study epidemiology, clinical profile, treatment strategies associated in children with MIS‑C in a medical college hospital in North India. Methods: This is an observational study of children with MIS-C, admitted to paediatric intensive care unit between 01March 2021 and 31 August 2021 during the second wave of SARS‑CoV‑2 infection in India. Demographic and clinical data including laboratory parameters, treatment regimens, and outcomes were collected and analyzed. Results: Out of the 37 children presenting with MIS‑C, sixty two percent patients were male and 37% were female patients. Fever was the most common symptom seen in all patients. Gastrointestinal system dysfunction was the most common systemic involvement seen in 72% patients. Anaemia was the most common sign of haematological dysfunction. Shock was seen in 37.84% patients and myocarditis was seen in 24.32% patients. Inflammatory markers were elevated in majority of children. Vasoactive medications were required in 14 patients. Eighteen patients required respiratory support of which 17 received non-invasive ventilation and only 1 patient required invasive mechanical ventilation. Methyl prednisolone and intravenous immunoglobulin (IVIG) were used in the majority of patients. No patient required remdesivir. Thirty-six patients were discharged home with a median duration of 4 days in paediatric intensive care unit (PICU) and hospital stay of 10 days, only 1 (2.7%) patient died during the treatment. Conclusions: Combination of steroid and IVIG for the treatment of MIS-C, especially with shock and MODS reduce the duration of PICU stay than treated with steroid alone.