Table 1.
Clinical presentation of cases with MIS-C.
| Total population (N = 239)a | Group 1 Toxic shock syndrome like (N = 61) | Group 2 Kawasaki like (N = 70) | Group 3 Nonspenspecific (N = 108) | p-valueb | |
|---|---|---|---|---|---|
| Female sex - no. (%) | 103 (43.1%) | 29 (47.5%) | 30 (43.5%) | 44 (40.7%) | 0.68 |
| Age median (IQR) | 7.8 (2.6–13.2) | 11.0 (7.1–14.4) | 6.8 (2.4–10.5) | 6.2 (1.9–13.4) | <0.001 |
| <1 year | 30 (12.6%) | 2 (6.7%) | 6 (20%) | 22 (73.3%) | |
| 1–4 years | 57 (23.9%) | 7 (12.3%) | 26 (45.6%) | 24 (42.1%) | |
| 5–9 years | 54 (22.6%) | 14 (25.9%) | 19 (35.2%) | 21 (38.9%) | |
| 10–14 years | 67 (28.03%) | 28 (41.8%) | 17 (25.4%) | 22 (32.8%) | |
| 15–18 years | 31 (13.0%) | 10 (32.3%) | 2 (6.5%) | 19 (61.3%) | |
| Days with symptoms before admission | 6 (4–9) | 7 (4–8) | 4 (2–6) | 7 (4–10) | <0.001 |
| SARS-CoV2 infection evidence | |||||
| Positive RT- PCR test | 105/182 (57.7%) | 40/57 (70%) | 16/54 (29.6%) | 49/71 (69%) | <0.001 |
| Positive rapid antigen test | 46/129 (35.7%) | 14/34 (41.2%) | 9/44 (20%) | 23/51 (45.1%) | 0.03 |
| Positive RT-PCR or rapid antigen test | 130/213 (61.0%) | 47/60 (78%) | 23/65 (35.4%) | 60/88 (68.2%) | <0.001 |
| Positive serologyc | 114/160 (71.3%) | 24/37 (64.9%) | 43/52 (82.7%) | 47/71 (66.2%) | 0.08 |
| Previous comorbidities | |||||
| Obesity (BMI > 95th percentile) | 38 (15.9%) | 5 (8.6%) | 12 ((17.6%) | 21 (19.4%) | 0.17 |
| Respiratory | 11 (4.6%) | 3 (6.7%) | 2 (10.5%) | 6 (9.8%) | 0.76 |
| Neuromuscular | 14 (15.9%) | 5 (11.1%) | 3 (15.8%) | 6 (9.8%) | 0.69 |
| Cardiovascular | 6 (2.5%) | 1 (2.2%) | 0 | 5 (8.2%) | 0.25 |
| Cancer | 16 (6.7%) | 7 (15.6%) | 0 | 9 (14.8%) | 0.18 |
| Immunosuppression | 3 (1.3%) | 2 (4.4%) | 0 | 1 (1.6%) | 0.74 |
| At least one underlying condition | 83 (34.7%) | 24 (39.3%) | 17 (24.3%) | 42 (38.9%) | 0.09 |
| Severe underlying condition | 41 (17.5%) | 15 (24.6%) | 4 (5.7%) | 22 (20.4%) | 0.004 |
| Clinical presentation | |||||
| Rash | 98 (41%) | 30 (49.2%) | 49 (70%) | 19 (17.6%) | <0.001 |
| Conjunctivitis | 118 (49.4%) | 32 (52.5%) | 59 (84.3%) | 27 (25%) | <0.001 |
| Diarrhea | 80 (33.5%) | 25 (41.0%) | 23 (32.9%) | 32 (29.6%) | 0.31 |
| Emesis | 86 (36.0%) | 29 (47.5%) | 29 (41.4%) | 28 (25.9%) | 0.01 |
| Abdominal pain | 91 (38.1%) | 43 (70.5%) | 33 (47.1%) | 15 (13.9%) | <0.001 |
| Rhinorrhea | 57 (23.8%) | 22 (36.1%) | 21 (30%) | 14 (13%) | 0.001 |
| Respiratory dysfunction | 150 (62.8%) | 54 (88.5%) | 25 (35.7%) | 71 (65.7%) | <0.001 |
| Anosmia/Dysgeusia | 11 (4.6%) | 5 (8.2%) | 2 (2.9%) | 4 (3.7%) | 0.33 |
| Arthralgias/Myalgias | 48 (20.1%) | 13 (21.3%) | 22 (31.4%) | 13 (12.0%) | 0.007 |
| Laboratory findings | |||||
| Neutrophil count ×106 cells/mcl | 8.1 (4.2–13.6) | 6.5 (1.7–12.2) | 9.5 (6.3–14.9) | 7.7 (3.7–12.5) | 0.02 |
| Neutrophilia (>7,500 cells/mcl) | 130/238 (54.6%) | 30 (49.2%) | 46/69 (66.7%) | 54 (50%) | 0.06 |
| Neutropenia (<1,000 cells/mcl) | 22/239 (9.2%) | 7 (11.5%) | 2 (2.9%) | 13 (12%) | 0.07 |
| Lymphocyte count ×106 cells/mcl | 1.4 (0.6–2.6) | 0.8 (0.4–1.7) | 1.3 (0.9–2.2) | 1.8 (0.9–3.4) | <0.001 |
| Lymphopeniad | 165/237 (69.6%) | 44/60 (73.3%) | 56/69 (81.2%) | 65 (60.2%) | 0.01 |
| Lymphocite count <1,000 cells/mcl | 82/237 (34.6%) | 35 (57.4%) | 19 (27.5%) | 28 (25.9%) | <0.001 |
| Platelets ×103 cells/mcl | 173 (96–315) | 104 (64–165) | 193 (99–329) | 216 (148–365) | <0.001 |
| Platelets <150 × 103 cells/mcl | 93/239 (38.9%) | 41 (67.2%) | 25 (35.7%) | 27 (25%) | <0.001 |
| Fibrinogen, mg/dl | 427 (298–559) | 508 (348–617) | 401 (306–549) | 391 (256–531) | 0.24 |
| Fibrinogen >400 mg/dl | 104/183 (56.8%) | 39/58 (67.2%) | 24/51 (47.1%) | 41/74 (55.4%) | 0.10 |
| Ferritin, mcg/L | 557 (304–1,209) | 828 (508–1,956) | 437 (213–793) | 530 (252–1,209) | <0.001 |
| Ferritin >300 mg/dl | 144/191 (75.4%) | 50/54 (92.6%) | 39/59 (66.1%) | 55/78 (70.5%) | 0.001 |
| Ferritin >1,500 mg/dl | 32/191 (16.7%) | 14/54 (25.9%) | 2/59 (3.4%) | 16/78 (20.5%) | 0.001 |
| D-Dimer ng/ml | 2.2 (1–5) | 4.3 (1.7–9.2) | 2.1 (1.0–3.8) | 1.6 (0.8–4.0) | <0.001 |
| D-Dimer >560 ng/ml (0.56 ng/L) | 194/219 (88.6%) | 55/58 (94.8%) | 57/67 (85.1%) | 82/94 (87.2%) | 0.178 |
| C-reactive protein (mg/L) | 60 (17–180) | 15 (7–31.5) | 38.7 (14.6–179.5) | 22.5 (7.3–86.9) | 0.85 |
| C-reactive protein >5 mg/L | 200/225 (88.9%) | 50/56 (89.3%) | 62/68 (91.2%) | 88/101 (87.1%) | 0.71 |
| Procalcitonin ng/ml | 0.85 (0.14–3.6) | 1.9 (0.5–4.8) | 0.5 (0.0–2.5) | 0.5 (0.1–2.5) | 0.005 |
| Procalcitonin >0.15 ng/ml | 126/171 (73.7%) | 49/55 (89.1%) | 27/41 (65.9%) | 50/75 (66.7%) | 0.005 |
| Albumin <3 g/dl | 133/222 (59.9%) | 51/61 (83.6%) | 40/66 (60.6%) | 42/95 (44.2%) | <0.001 |
a
N in the column heading was used to calculate proportions if not otherwise specified. For variables with missing data, denominators are reported in each cell.
b
One-sided Fisher exact test/Mann–Whitney test for comparison between groups 1, 2, and 3.
c
Nucleocapsid antibody in all cases.
d
Lymphopenia: <2 years: <4,000, 2–3 years: <3,000, >4 years: <1,500 cells/mcl.