In high-income nations, the clinical presentation and severity of Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C) is widespread, with a very low fatality rate. The clinical characteristics of MIS-C in critically ill children in middle-income countries, as well as the factors linked to death and patients with critical outcomes, are described in this study. Observational cohort research was conducted between April 1, 2020, and January 31, 2021, in 14 pediatric intensive care units (PICUs) in Colombia. The patients’ ages ranged from one month to eighteen years, and each met the World Health Organization’s (WHO) MIS-C standards.
This study included 78 youngsters. The median age was 7 years (IQR 1-11), and 18% (14/78) of the children were under the age of one. Males made up 56% of the population. Obesity or overweight was seen in 35% of the patients (29/78). Individuals spent an average of 6 days in the PICU (IQR 4-7), and 100% of them had a fever that lasted at least 5 days when they arrived at the clinic (IQR 3.7-6). 70% of patients (55/78) had diarrhea, and 87% (68/78) had a shock or systolic myocardial failure. They detected Aneurysms in the coronary arteries in 35% of the cases (27/78), and pericardial effusion was found in 36%. There was a greater mortality rate (9% vs. 1.8%; p=0.001) than available statistics in high-income nations. There was a greater mortality rate (9% vs. 1.8%; P=0.001) than available statistics in high-income countries. When comparing the group of patients who did not survive, researchers discovered a higher incidence of ferritin levels above 500 ngr/mL (100%vs. 45%; p=0.012) and more cardiovascular problems (100% vs. 54%; P=0.019). Immunoglobulin (91%) was the most common treatment, followed by vasoactive support (76%), steroids (70.5%), and antiplatelets (44%). The clinical, biochemical, and echocardiographic aspects of Multisystem Inflammatory Syndrome in Children due to SARS-CoV-2 in critically ill children residing in a middle-income nation are similar to those described in high-income countries. The reported inflammatory response and cardiovascular involvement were variables that may explain why these children had a greater fatality rate when combined with the later presentation.
Reference:bmcpediatr.biomedcentral.com/articles/10.1186/s12887-021-02974-9
