Document Type : original article
Authors
- Seyed Hesamedin Nabavizadeh 1, 2
- Mina Esmailli 3
- Hossein Esmaeilzadeh 1, 2
- Soheila Alyasin 1, 2
- Aida Askarisarvestani 1
1 Division of Allergy and Clinical Immunology, Department of Pediatrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
2 Allergy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
3 Clinical Pediatrician, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a rather newly described entity that can potentially end in multisystem failure in children following COVID-19 infection. The prognosis of patients with MIS-C is multifactorial; consequently, many risk factors increase the risk of mortality and severity of this disease. In this study we aimed to evaluate the prognostic effect of various parameters in mortality and intensive care unit admission of patients with MIS-C.
Methods: in this cross-sectional study, the information of patients with MIS-C were extracted in a tertiary pediatric center during a one-year period. The relationship between mortality and ICU admission of the patients with demographic information and lab data were assessed.
Results: a total of 88 male-predominant (56.8% vs. 43.2%, P=0.135) entered the study. Seven patients had expired and 71 patients were discharged from the hospital. In our study, demographic information of the patients and their lab data were not associated with mortality except for Lactate Dehydrogenase (LDH) level. All of the expired patients had elevated LDH, while only 53.1% of the discharged patients showed increased LDH (P=0.016); on the other hand, LDH did not differ between patients who were managed in ICUs and the ones who were managed in wards.
Conclusion: LDH can be counted as a prognostic tool for mortality in MIS-C and might be regarded as a part of evaluation for ICU admission in this disease.
Keywords
- Salian VS, Wright JA, Vedell PT, Nair S, Li C, Kandimalla M, Tang X, Carmona Porquera EM, Kalari KR, Kandimalla KK. COVID-19 Transmission, Current Treatment, and Future Therapeutic Strategies. Mol Pharm. 2021 Mar 1; 18(3):754-771. doi: 10.1021/acs.molpharmaceut.0c00608. Epub 2021 Jan 19. PMID: 33464914; PMCID: PMC7839412.
- Rahman S, Montero MTV, Rowe K, Kirton R, Kunik F Jr. Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence. Expert Rev Clin Pharmacol. 2021 May; 14(5):601-621. doi: 10.1080/17512433.2021.1902303. Epub 2021 May 3. PMID: 33705239; PMCID: PMC8095162.
- Hu B, Huang S, Yin L. The cytokine storm and COVID-19. J Med Virol. 2021 Jan; 93(1):250-256. doi: 10.1002/jmv.26232. Epub 2020 Sep 30. PMID: 32592501; PMCID: PMC7361342.
- Hoste L, Van Paemel R, Haerynck F. Multisystem inflammatory syndrome in children related to COVID-19: a systematic review. Eur J Pediatr. 2021 Jul; 180(7):2019-2034. doi: 10.1007/s00431-021-03993-5. Epub 2021 Feb 18. PMID: 33599835; PMCID: PMC7890544.
- Centers for Disease Control and Prevention. Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). 2020 December 23, 2022; Available from: https://emergency.cdc.gov/han/2020/han00432.asp.
- World Health Organization. Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19. 2020 December 23, 2022; Available from: https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19.
- Santos MO, Gonçalves LC, Silva PAN, Moreira ALE, Ito CRM, Peixoto FAO, Wastowski IJ, Carneiro LC, Avelino MAG. Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes. J Pediatr (Rio J). 2022 Jul-Aug; 98(4):338-349. doi: 10.1016/j.jped.2021.08.006. Epub 2021 Dec 3. PMID: 34863701; PMCID: PMC9432310.
- Jiang L, Tang K, Irfan O, Li X, Zhang E, Bhutta Z. Epidemiology, Clinical Features, and Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) and Adolescents-a Live Systematic Review and Meta-analysis. Curr Pediatr Rep. 2022; 10(2):19-30. doi: 10.1007/s40124-022-00264-1. Epub 2022 May 6. PMID: 35540721; PMCID: PMC9072767.
- La Torre F, Taddio A, Conti C, Cattalini M. Multi-Inflammatory Syndrome in Children (MIS-C) in 2023: Is It Time to Forget about It? Children (Basel). 2023 May 31; 10(6):980. doi: 10.3390/children10060980. PMID: 37371212; PMCID: PMC10297102.
- Cetin BS, Kısaarslan AP, Tekin S, Goksuluk MB, Baykan A, Akyıldız BN, Seçilmiş Y, Poyrazoglu H, On Behalf Of The Erciyes Mis-C Study Group. Evaluation of Baseline Characteristics and Prognostic Factors in Multi Systemic Inflammatory Syndrome in Children: Is It Possible to Foresee the Prognosis in the First Step? J Clin Med. 2022 Aug 8; 11(15):4615. doi: 10.3390/jcm11154615. PMID: 35956234; PMCID: PMC9369528.
- Angurana SK, Awasthi P, Thakur A, Randhawa MS, Nallasamy K, Kumar MR, Naganur S, Kumar M, Goyal K, Ghosh A, Bansal A, Jayashree M. Intensive Care Needs and Short-Term Outcome of Multisystem Inflammatory Syndrome in Children (MIS-C): Experience from North India. J Trop Pediatr. 2021 Jul 2; 67(3):fmab055. doi: 10.1093/tropej/fmab055. PMID: 34170328; PMCID: PMC8344677.
- Alkan G, Sert A, Oz SKT, Emiroglu M, Yılmaz R. Clinical features and outcome of MIS-C patients: an experience from Central Anatolia. Clin Rheumatol. 2021 Oct; 40(10):4179-4189. doi: 10.1007/s10067-021-05754-z. Epub 2021 May 6. PMID: 33956250; PMCID: PMC8100744.
)