Background and Objectives: Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 is a hyper inflammatory syndrome manifesting commonly with a cytokine storm that causes wide spread multi organ involvement.
Aim: To study the clinical profile & outcome of multisystem inflammatory syndrome in children (MIS-C) related to covid-19 infection.
Methodology: This retrospective study was done in Pediatric Intensive Care Unit of a tertiary care teaching hospital. Case records of children with discharge diagnosis of MIS-C, full filling the WHO criteria were included. The cases were categorized into two subsets based on presentation: with shock and without shock. Demographic parameters, clinical symptomatology, laboratory parameters, echocardiography findings and treatment were compared between these two groups. Coronary artery diameter was measured by using Z score in echocardiography. Outcome of the study was measured in terms of mortality or discharged.
Results: During the study period, 96 children presented with signs and symptoms suggestive of MIS-C and out of them 63 children fulfilled the WHO MIS-C criteria. The mean age of study population was 6.8 \(\pm\) 5.31years (1 month-17 years). Majority of cases were in the age group of 0-5 years (47.61%) with male preponderance of 55.55%. Half (50.79%) of the children presented with shock and maximum cases were in 6-12 years of age group (p=0.008). Most common presenting symptoms were vomiting and rash observed in 58.73% children each. C reactive protein (p=0.001) and Sr Ferritin (p=0.009) were significantly higher in children with shock. Echocardiography was done in 38 children and 30(78.94%) of them had abnormalities. Left ventricular dysfunction was significantly higher in children with shock as compared to those without shock (p=0.02). Majority of children who presented with shock required IVIg along with steroids as against those presented without shock(p=0.003). Mortality was 12.7%.
Conclusion: Shock was a common manifestation in MISC, affecting half of the children. CRP, Sr ferritin and echocardiography abnormality were significantly higher in children with shock. Majority of the children with shock required IVIg along with steroids.
