Children older than 5 at higher risk of COVID-19-related multisystem inflammatory syndrome

Most patients (89%) had gastrointestinal symptoms such as pain and dermatological problems like rashes and swelling (85%). Cardiac involvement was common (59%), as were abnormalities in blood coagulation (90%). Of the 232 children, 73 (31.5%) were admitted to ICU, and 47 (64%) of them needed treatment for very low blood pressure.

The risk of admission to the ICU was higher in children aged 6-12 years (44%) and 13-17 years (46%) than in children aged 0–5 years (18%). As well, children admitted to hospital later in the pandemic (between November 2020 and March 2021) were more likely to be admitted to the ICU (50 of 112, 45%) than those hospitalized earlier (23 of 120, 19%).

The authors note challenges in diagnosing MIS-C.

"Multisystem inflammatory syndrome in children is a new diagnosis, with differing diagnostic criteria that have not been validated," writes Dr. Joan Robinson, a pediatrician at the University of Alberta, Edmonton, Alberta, with coauthors.

"Most of these children lacked a history of contact with a person with proven SARS-CoV-2 infection. Identifying exposure can be difficult as infected contacts may be asymptomatic or may never have been tested."

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10.1503/cmaj.21087