Author(s):
Lima-Setta,Fernanda ; Magalhães-Barbosa,Maria Clara de ; Rodrigues-Santos,Gustavo ; Figueiredo,Elaine Augusta das Neves ; Jacques,Melissa de Lorena ; Zeitel,Raquel de Seixas ; Sapolnik,Roberto ; Borges,Cibelle Teixeira da Siva ; Lanziotti,Vanessa Soares ; Castro,Roberta Esteves Vieira de ; Bellinat,Ana Paula Novaes ; Silva,Thiago Peres da ; Oliveira,Felipe Rezende Caino de ; Reis,Bárbara Carvalho Santos dos ; Castro,Natália Almeida de Arnaldo Silva Rodriguez ; Macedo,João Henrique Garcia Cobas ; Scarlato,Ana Carolina Cabral Pinheiro ; Riveiro,Paula Marins ; Mota,Isabele Coelho Fonseca da ; Lorenzo,Vivian Botelho ; Lucena,Natalia Martins Lima de ; Azevedo,Zina Maria Almeida de ; Cunha,Antonio José L.A. ; Prata-Barbosa,Arnaldo
Date: 2021
Origin: Oasisbr
Subject(s): SARS-CoV-2; Multisystem inflammatory syndrome in children; MIS-C; Coronavirus; COVID-19; Children
Description
Abstract Objective To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes of children with MIS-C. Method Multicenter, prospective cohort study, conducted in 17 pediatric intensive care units in five states in Brazil, from March to July 2020. Patients from 1 month to 19 years who met the MIS-C diagnostic criteria were included consecutively. Results Fifty-six patients were included, with the following conditions: Kawasaki-like disease (n = 26), incomplete Kawasaki disease (n = 16), acute cardiac dysfunction (n = 10), toxic shock syndrome (n = 3), and macrophage activation syndrome (n = 1). Median age was 6.2 years (IQR 2.4−10.3), 70% were boys, 59% were non-whites, 20% had comorbidities, 48% reported a contact with COVID-19 cases, and 55% had a recent SARS-CoV-2 infection confirmed by RT-PCR and/or serology. Gastrointestinal symptoms were present in 71%, shock symptoms in 59%, and severe respiratory symptoms in less than 20%. -Dimer was increased in 80% and cardiac dysfunction markers in more than 75%. Treatment included immunoglobulin (89%); corticosteroids, antibiotics, and enoxaparin in about 50%; and oseltamivir and antifungal therapy in less than 10%. Only 11% needed invasive mechanical ventilation, with a median duration of five days (IQR 5–6.5). The median length of PICU stay was six days (IQR 5–11), and one death occurred (1.8%). Conclusions Most characteristics of the present MIS-C patients were similar to that of other cohorts. The present results may contribute to a broader understanding of SARS-CoV-2 infection in children and its short-term consequences. Long-term multidisciplinary follow-up is needed, since it is not known whether these patients will have chronic cardiac impairment or other sequelae.
