Clinical profile, cardiac involvement and outcome of children admitted with multisystem inflammatory syndrome in PICU at GB Pant children hospital Srinagar
Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe hyper inflammatory post infectious complication of acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, which typically occurs 2-6 weeks after exposure to SARS-CoV-2. Aim was to determine the clinical profile, cardiac involvement and outcome of children admitted with multisystem inflammatory syndrome in pediatric intensive care unit. Methods: This prospective observational study was conducted in pediatric intensive care unit over period of two years. After informed consent from parents, all those patients meeting inclusion criteria were subjected to complete history, general and systemic physical examination. Routine baseline investigations included CBC, LFT, KFT, ABG, serum calcium and phosphorous, and other investigations like echocardiography, COVID-19 RAT and RTPCR and various inflammatory markers like serum ferritin, pro-calcitonin, CRP and ESR whenever required were done. Results: In our study out of 77 MIS-C patients 40 were males and 37 were females with a male female ratio of 1.1:1. The mean average age was 7.4 years. Out of them 47 (61%) patients had a history of COVID-19 infection/contact with positive COVID-19 cases 3 to 4 weeks before presentation. In our study gastrointestinal, respiratory, and cardiac systems were mostly involved. Rash and conjunctival congestion was seen in 81% of MIS-C patients. On echocardiography out of 77 MIS-C patients, 15 (19.5%) had pericardial effusion, 25 (32.5%) had coronary artery dilatations and 32 patients (41.5%) had left ventricular systolic dysfunction with LVEF Conclusions: Pediatric multisystem inflammatory syndrome is a serious and life-threatening illnesses having a significant impact on morbidity and mortality.