Table 2.
Clinical Features, Treatment, and Outcome of Multisystem Inflammatory Syndrome in Children (MIS-C). Clinical data extracted from Verdoni et al [47], Belhadjer et al [46], Whittaker et al [49], Cheung et al [50], Chiotos et al [48] and Waltuch et al [4] and grouped by country. For simplicity, Chiotos et al and Waltuch et al study information were combined.
| Italy | France and Switzerland | United Kingdom | United States | Summary | |
|---|---|---|---|---|---|
| Reference Source | Verdoni et al (Bergamo, Italy) | Belhadjer et al. (13 hospitals in France and 1 hospital in Switzerland) | Whittaker et al. (8 hospitals in the UK; includes 8 patients from Riphagen et al.) | § - Cheung et al (Morgan Stanley Children's Hospital, New York); ¶ - Chiotos et al (CHOP, Philadelphia) and Waltuch et al (Mount Sinai, New York) | |
| Number | 10 | 35 | 58 | § - 17 ¶ - 10 | 130 |
| Age (median + IQR) | 7.45 (6.5 – 8.45) | 10 | 9 (5.7 – 14) | § - 8 (1.8 – 16) ¶- 9.5 (5.25 – 12) | |
| Sex (%M) | 70% | 51% | 43% | 44% | |
| Reported Race/Ethnicity | N/A | N/A | 22 black, 18 Asian, 12 white, 6 other | 6 black, 4 Non-Hispanic white, 4 Hispanic, 6 Ashkenazi Jewish, 1 Asian, the rest unknown | |
| COVID Status | |||||
| COVID AB Assay positive | 8 | 30 | 40 | 18 | 74% |
| RT-PCR positive | 2 | 14 | 15 | 11 | 32% |
| Symptoms | |||||
| Fever | 6 Abdominal5 Complete KD5 Incomplete KD | 35 | 58 | 27 | 100% |
| Abdominal Symptoms | 29 | 31 | 24 | 70% | |
| Respiratory Symptoms | 23 | 12 | 13 | 40% | |
| Skin Rash | 20 | 30 | 16 | 55% | |
| Conjunctivitis | 31 | 26 | 16 | 61% | |
| Lymphadenopathy | 21 | 9 | 7 | 31% | |
| Extremity Edema | N/A | 9 | 2 | 26% | |
| Fissured lips/Strawberry Tongue | *&*) | 19 | 17 | 13 | 41% |
| Cardiac Features | |||||
| Chest pain | 0 | 6 | 0 | 0 | 5% |
| Shock (requiring fluids or vasoactives) | 5 | 28 | 27 | 23 | 64% |
| Arrhythmia | 0 | 1 | 4 | 3 | 6% |
| Coronary artery dilation (z-score >2; or >4 mm) | 2 | 6 | 8 (2 giant coronary artery aneurysms) | 4 (7 with prominent/echogenic coronaries) | 15% |
| Decreased ventricular function (EF < 55%) | 5 | 35 | 18 | 15 | 56% |
| Respiratory Features | |||||
| Positive CXR finding | 5 | N/A | N/A | 17 | |
| Non-invasive | N/A | 11 | N/A | 4 | |
| Mechanical Vent | N/A | 22 | 25 | 12 | |
| Treatment | |||||
| Vasoactive Support | 2 | 28 | 27 | 17 | 57% |
| IVIG | 10 | 25 | 41 | 22 | 75% |
| Steroids | 8 | 12 | 37 | 19 | 59% |
| IL-1 receptor antagonist (Anakinra) | 0 | 3 | 3 | 2 | 6% |
| IL-6 receptor antagonist (tocilizumab) | 0 | 0 | 0 | 4 | 3% |
| TNF-alpha antagonist (Infliximab) | 0 | 0 | 8 | 0 | 6% |
| Outcomes | |||||
| VA-ECMO | 0 | 10 | 3 | 0 | 10% |
| Death | 0 | 0 | 1 | 0 | 0.77% |
AB: Antibody, CXR: chest X-ray, EF: Ejection fraction, IVIG: Intravenous immunoglobulin, IL: Interleukin, KD: Kawasaki disease, N/A: not available, VA-ECMO: Veno-arterial extracorporeal membrane oxygenation.