Abstract
Objectives
We describe the presentation, treatment and outcome of children with multisystem inflammatory syndrome with COVID-19 (MIS-C) in Mumbai metropolitan area in India.
Methods
This is an observational study conducted at four tertiary hospitals in Mumbai. Parameters including demographics, symptomatology, laboratory markers, medications and outcome were obtained from patient hospital records and analyzed in patients treated for MIS-C (as per WHO criteria) from 1 May, 2020 to 15 July, 2020.
Results
23 patients (11 males) with median (range) age of 7.2 (0.8–14) years were included. COVID-19 RT-PCR or antibody was positive in 39.1% and 30.4%, respectively; 34.8% had a positive contact. 65% patients presented in shock; these children had a higher age (P=0.05), and significantly higher incidence of myocarditis with elevated troponin, NT pro BNP and left ventricular dysfunction, along with significant neutrophilia and lymphopenia, as compared to those without shock. Coronary artery dilation was seen in 26% patients overall. Steroids were used most commonly for treatment (96%), usually along with intravenous immunoglobulin (IVIg) (65%). Outcome was good with only one death.
Conclusion
Initial data on MIS-C from India is presented. Further studies and longer surveillance of patients with MIS-C are required to improve our diagnostic, treatment and surveillance criteria.
Keywords: PIMS-TS, Kawasaki disease, Myocarditis, COVID-19, SARS-CoV-2
Acknowledgements
The following pediatricians, pediatric intensivists and pediatric cardiologists who were involved in the clinical care of the patients studied: Dr Jayashree Mishra, Dr Amish Vora, Dr Aoyan Sengupta, Dr Bharat Parmar, Dr Indu Khosla, Dr Shashank Parekhji, Dr Sudhir Sane and Dr Priya Pradhan. We would also like to thank Dr Tanu Singhal for her expert advice in the preparation of the manuscript.
Contributors
SK, SS, SL, SV, TK, PA, LS, SU: contribution to the conception and design of the work, preparation and finalization of the draft; SL, SJ, PB, SS: contributions to the acquisition, analysis, and interpretation of data for the work; SK, SS, PB, SU: critical revision. All authors approved the final version of the manuscript.
Funding
None
Ethics clearance
Institutional Ethics Committee (IEC) BJ Wadia Hospital for Children; No. IEC-BJWHC/66/2020, dated July 18, 2020. SRCC Children’s Hospital Ethics Committee; No R-202010, dated June 30, 2020. Jupiter Hospital IEC; dated July 8, 2020. KDAH Ethics Committee; ECR/141/Inst/MH/2013/RR-19, dated June 6, 2020.
Footnotes
Competing interests
None stated.
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