During pandemic COVID-19 in majority of children presented less severe phenotype, multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 subsequently evolved as a post-infectious inflammatory condition associated with severe clinical deterioration and multi organ involvement.
Aim of the study was to assess the clinical and lab characteristics and outcomes of MIS-C in Georgia. The study comprised 89 children with MIS-C admitted to Iashvili children’s central hospital from December 2020 to October 2022. Data were obtained from medical record retrospectively.
58 (54.2%) of patients were male. Median age of patients was 8.5 (1-17) years. The most common presenting symptoms were - fever (100%), gastrointestinal (GI) (68%), rash (48.1%) and vomiting (46%) were. Average fever duration was 9 (4 -12) days. Shock and/or hypotension were common in patients with MIS-C (24%). In total, 38.7% of the patients admitted to pediatric intensive care unit and 19.3% received vasopressor support. 20% of patient had depressed left ventricular ejection fraction. Cardiac symptoms (69%) predominated over respiratory (40%) and neurological (32%) symptoms. Admission lab findings - elevated CRP -99.8%, procalcitonine-97.1%, erythrocyte sedimentation rate-98%, D-dimer-98.8% and ferritin-78%; Lymphopenia-98.9%, neutrophilia - 96% and hypoalbuminemia 40.3%. 38% received IV Intravenous immunoglobulin, 98.2% - corticosteroids; Anakinra was not used in our clinic. Median duration of hospital length of stay was 14.5 days. Comorbidities were present in 1.1% of the patients. No mortality was recorded.
While being rare MIS-C has very severe presentation that need early recognition and aggressive treatment. The increasing number of MIS-C cases shows that this phenomenon is more common than was thought at the beginning of pandemic. Here is not enough evidence about the long-term consequences yet and we conduct monitoring and evaluation of patients in dynamics.
Keywords: COVID-19; SARS-CoV2; children; multisystem inflammatory syndrome in children (MIS-C).