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Children older than 5 at higher risk of COVID-19-related multisystem inflammatory syndrome
The international study included 232 children younger than 18 admitted to 1 of 15 centres-13 in Canada, 1 in Costa Rica and 1 in Iran-for suspected MIS-C between March 1, 2020, and March 7, 2021. The patients met the World Health Organization's definition for MIS-C, which includes fever persisting for at least 3 days; elevated C-reactive protein, which indicates inflammation; illness involving 2 or more systems with no obvious microbial cause of inflammation; and positivity for COVID-19 or suspected contact with a positive case.
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."
For more information, check out the following link:
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751