Table 2.
Treatment and outcomes of cases with MIS-C.
| Total sample (N = 239)a | OR (IC 95%b) | Between centers heterogeneity I2 (p) | Group 1 Toxic shock like (N = 61) | Group 2 Kawasaki like (N = 70) | Group 3 Nonspecific (N = 108) | p-valuec | |
|---|---|---|---|---|---|---|---|
| Treatment – no. (%) | |||||||
| Intravenous immune globulin | 172 (42.0%) | 0.76 (0.58–0.94) | 70.3% (<0.001) | 49 (80%) | 65 (93%) | 58 (53.7%) | <0.001 |
| Systemic steroids | 187 (78.2%) | 0.81 (0.67–0.94) | 54.1% (<0.001) | 52 (85%) | 64 (91%) | 71 (66%) | <0.001 |
| Anticoagulation therapy | 99 (41.4%) | 0.35 (0.10–0.60) | 96.4% (<0.001) | 42 (69%) | 16 (23%) | 41 (38%) | <0.001 |
| Ventilatory support needed - no (%) | |||||||
| Any oxygen supplementation | 143 (59.8%) | 0.54 (0.34–0.72) | 94.5% (<0.001) | 57 (93.4%) | 30 (43%) | 56 (52%) | <0.001 |
| Non-invasive mechanical ventilation | 14 (5.9%) | 0.07 (0.01–0.13) | 62.5% (0.0) | 8 (13%) | 0 | 6 (5.6%) | 0.006 |
| Invasive mechanical ventilation | 57 (23.9%) | 0.19 (0.04–0.33) | 91.7% (>0.001) | 41 (67.2) | 0 | 16 (15%) | <0.001 |
| Any infiltrates in chest Rx or CTd | 127/224 (56.7%) | 0.46 (0.22–0.71) | 94.1% (<0.001) | 46 (75%) | 19 (27%) | 62 (57%) | <0.001 |
| Severe respiratory involvmente | 82/239 (34.3%) | 0.32 (0.19–0.44) | 75.7% (<0.001) | 36 (59%) | 16 (22%) | 30 (27%) | <0.001 |
| Cardiovascular involvement | |||||||
| LVEFe < 55% | 61/194 (31.4%) | 0.43 (0.31–0.55) | 47.6% (0.13) | 25 (41%) | 7 (10%) | 29 (27%) | <0.001 |
| LVEF < 45% | 20/194 (10.3%) | 0.14 (0.06–0.22) | 37.8% (0.19) | 7 (12%) | 1 (1.4%) | 12 (11%) | 0.02 |
| LVEF < 35% | 10/194 (5.2%) | 0.04 (0.01–0.11) | – | 3 (5%) | 0 | 7 (7%) | 0.05 |
| Coronary aneurysm (z > 2.5) | 21/159 (13.2%) | 0.19 (0.06–0.32) | 61% (0.04) | 6 (10%) | 6 (9%) | 9 (8%) | 0.87 |
| Coronary dilatation (z: 2–2.5) | 9/159 (5.7%) | 0.12 (0.04–0.21) | 0% (0.48) | 1 (2%) | 4 (6%) | 4 (4%) | 0.47 |
| Vasopressor support – no (%) | 92/235 (39.2%) | 0.35 (0.10–0.6) | 96.4% (<0.001) | 48 (79%) | 4 (6%) | 40 (37%) | <0.001 |
| Hematologic involvement | |||||||
| INR > 1.2 | 104/233 (44.6%) | 0.46 (0.30–0.62) | 82.8% (<0.001) | 37 (61%) | 31 (44%) | 36 (33%) | 0.002 |
| Platelets count <150,000 cell/mcl | 93 (38.9%) | 0.40 (0.31–0.48) | 41.2% (0.12) | 41 (67%) | 25 (36%) | 27 (25%) | <0.001 |
| Neurologic involvement | 16 (6.7%) | 0.06 (0.03–0.09) | 0% (0.74) | 3 (5%) | 4 (6%) | 9 (8.3%) | 0.43 |
| Gastrointestinal involvement | 175 (73%) | 0.74 (0.60–0.89) | 89.2% (<0.001) | 55 (90%) | 57 (80%) | 63 (58%) | <0.001 |
| Alanine Aminotransferase >90 U/L | 53/203 (26.1%) | 0.24 (0.15–0.33) | 52.2% (0.06) | 19 (31%) | 14 (20%) | 20 (19%) | 0.08 |
| Mucocutaneous involvement | 192 (80.3%) | 0.83 (0.72–0.93) | 80.9% (<0.001) | 52 (81%) | 70 (100%) | 70 (69%) | <0.001 |
| Acute Kidney Injuryf | 35/226 (15.5%) | 0.14 (0.09–0.20) | 33.9% (0.20) | 20 (33%) | 6 (9%) | 9 (8%) | <0.001 |
| ICUg admission | 130 (54.4%) | 0.43 (0.17–0.69) | – | 52 (85%) | 42 (60%) | 36 (33%) | <0.001 |
| Length of ICU stay, days (n = 129) | 4 (2–7) | – | – | 5 (3–8) | 3 (2–6) | 4 (2–7) | 0.34 |
| Length of Hospital stay days | 8 (5–13) | – | – | 10 (6–17) | 8 (6–12) | 8 (4–13) | 0.10 |
| Any cause in-hospital deaths | 13 (5.4%) | 0.05 (0.01–0.09) | 40.1% (0.17) | 9 (15%) | 0 | 4 (4%) | <0.001 |
| Died from SARS COV-2 | 11 (4.6%) | 0.04 (0.0–0.08) | 54.5% (0.09) | 8 (13%) | 0 | 3 (3%) | <0.001 |
a
N was used to calculate proportions if not otherwise specified. For variables with missing data, denominators are reported in each cell.
b
Exact confidence intervals by random effects metaanalisis of eight centers data. This analysis excludes centers with frequencies =0% and 100%, which explains the difference in point estimate with the first column.
c
Exact Fisher Kruskal Kruskal Wallis as suitable for comparison between groups 2 and 3.
d
Rx: chest x-ray, CT: Computed tomography.
e
LVEF, left ventricular ejection fraction.
f
Acute Kidney Injury (AKI) was defined as an increase greater than two times the upper limit of the reference range for gender and age.
g
ICU: intensive care unit.