Table 1.
Characteristics of children with SARS-CoV-2-related inflammatory multisystem syndrome (PIMS/MIS-C), KD from the French historic database (KD-HIS) and KD admitted to an ICU (KD-ICU)
| Characteristics | PIMS/MIS-Ca | KD-HIS | P-value | KD-ICUb | P-value |
|---|---|---|---|---|---|
| Demographics | |||||
| Age, years, mean (s.d.; range) | 8.8 (3.7; 0.3–17) | 2.8 (2.4; 0.1–14.4) | <0.0001 | 3.5 (3.1; 0.1–14.6) | <0.0001 |
| Sex (male), n/N (%) | 236/404 (59) | 242/424 (57) | 0.5 | 101/176 (57) | 0.6 |
| Duration of stay in ICU, days, median | 5.5 | 0 | – | 6.8 | – |
| Clinical features, n/N (%) | |||||
| Modifications of the extremities | 110/386 (28) | 292/417 (70) | <0.0001 | 58/84 (69) | <0.0001 |
| Diffuse exanthemac | 235/404 (58) | 320/399 (80) | <0.0001 | 71/84 (85) | <0.0001 |
| Conjunctivitis | 230/404 (57) | 374/421 (89) | <0.0001 | 72/84 (86) | <0.0001 |
| Buccal involvementd | 160/396 (40) | 350/413 (85) | <0.0001 | 75/84 (89) | <0.0001 |
| Cervical adenopathy ≥1.5 cm | 52/396 (13) | 219/397 (55) | <0.0001 | 48/84 (57) | <0.0001 |
| Complete KD (AHA criteria) | 100/346 (29) | 290/425 (68) | <0.0001 | 90/146 (62) | <0.0001 |
| Digestive symptoms/signs | 302/346 (88) | 226/414 (54) | <0.0001 | 58/70 (83) | 0.2 |
| Neurologic signs | 82/404 (20) | 68/407 (17) | 0.3 | 55/120 (46) | <0.0001 |
| Biological data e , mean (s.d.) (n) | |||||
| Lymphopeniaf, n/N (%) | 235/312 (75) | NA | – | NA | – |
| Platelet count (×109/l) | 217 (58) (218) | 385.2 (152.3) (406) | <0.0001 | 231 (113) (176) | 0.1 |
| CRP level at peak (mg/l) | 245 (119) (218) | 155.2 (97.1) (345) | <0.0001 | 262 (77) (115) | 0.2 |
| ALT level (IU/l) | 51 (124) (95) | 70.9 (99) (319) | 0.1 | 74 (50) (176) | 0.03 |
| Sodium level (mmol/l) | 129.9 (3.6) (53) | 134.5 (0.4) (356) | <0.0001 | 132.7 (2.3) (75) | <0.0001 |
| Elevated troponin | 231/389 (60) | NA | – | 6/11 (55) | 0.7 |
| Macrophage activation syndromef | 6/32 (19) | NA | – | 1/26 (4) | 0.08 |
| Abnormal chest X-ray | 107/231 (46) | 37/235 (16) | <0.0001 | 16/31 (52) | 0.5 |
| Cardiac complications (acute phase) , n/N (%) | |||||
| Coronary abnormalities | 48/404 (12) | 163/418 (39) | <0.0001 | 106/176 (60) | <0.0001 |
| Impaired LVSF and/or RV dysfunction | 193/338 (57) | NA | – | 34/103 (33) | <0.0001 |
| Pericardial effusion | 98/332 (30) | 75/413 (18) | 0.0001 | 23/87 (26) | 0.4 |
| Myocarditis | 59/136 (43) | 13/405 (3) | <0.0001 | 12/59 (20) | 0.002 |
| Mortality | 8/404 (2) | 0/425 | 0.003 | 5/176 (3) | 0.5 |
| Treatment, n/N (%) | |||||
| IVIG infusion | 314/404 (78) | 420/425 (99) | <0.0001 | 116/121 (96) | <0.0001 |
| Unresponsiveness to IVIG | 55/205 (27) | 94/348 (27) | NS | 76/159 (48) | <0.0001 |
| Corticosteroids | 219/404 (54) | 31/380 (8) | <0.0001 | 47/115 (41) | 0.01 |
| Aspirin | 50/61 (82) | 387/415 (93) | 0.004 | 91/94 (97) | 0.001 |
| Inotropic drugs | 213/404 (53) | 0/425 | – | 81/133 (61) | 0.1 |
a
Overall PIMS defined from a systematic review of the literature [2–4, 8–11, 35]. bOverall severe KD defined from a systematic review of the literature, including our series [21–24, 26, 27, 29, 30]. cErythema and/or oedema and/or desquamation. dCheilitis and/or mucosa erythema. eLaboratory results were the first reported. fDefined according to each article criteria. NA: not available; NS: not significant; LVSF: left ventricular systolic function; RV: right ventricle; Significant results are highlighted in bold.