highly varied clinical spectrum of MIS-C and its outcome based on timing of initiation of treatment
Abstract
Objectives: Multisystem inflammatory syndrome in children (MIS-C) related to severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) has recently been reported from several countries around the world including Pakistan. We describe clinical presentation, laboratory findings, treatment and prognosis of Children presenting with MIS-C in Children Hospital, PIMS Islamabad.
Methods: A retrospective observational study was carried out at West Medical Ward of Children Hospital, Pakistan Institute of Medical Sciences Islamabad. Children aged 1 month to 13 years, who fulfilled CDC criteria for MIS-C were included in study. Data was collected from patient records and phone calls and entered on a predesigned Performa. Data collection included demographic details, clinical presentation (symptoms, clinical examination findings), laboratory investigations and evidence of SARS-COV-2 infection, outcome and follow-up.
Results: We studied total 35 cases of MIS-C from June 2021 to December 2021. 28(80%) out of 35 patients were male and 7 (20%) were females. Fever was most persistent symptom found in 100% of patients. Involvement of cardiovascular system was found in 23 (65.70%) patients. Mean total leukocyte count (TLC) was 15.92±7.55×103/µL with 55.42±14.71% neutrophils and 36.73±14.36% lymphocytes. Mean value of CRP was 89.46±51.70mg/dl. Laboratory evidence of SARS-COV-2 was found in 28(80%) patients. Early diagnosis, early initiation of supportive management and treatment with IVIGs and corticosteroids was associated with good prognosis.
Conclusion: Clinical presentation of MIS-C is variable and affects multiple systems of body at one time. Immunotherapy with IVIGs and corticosteroids are mainstay of treatment and early diagnosis and early initiation of treatment is associated with good prognosis.
