Abstract
Objectives
To compare the clinical profile, treatment, and outcomes of PCR-positive and PCR-negative antibody-positive critically ill children with multisystem inflammatory syndrome (MIS-C).
Methods
This retrospective observational study was done at a tertiary care coronavirus disease 19 (COVID-19) pediatric intensive care unit in India. The baseline characteristics, clinical profile, treatment, and outcomes in seventeen critically ill children diagnosed with MIS-C were analyzed from 1 July to 31 October, 2020.
Results
Sixteen out of 17 children presented with hypotensive shock and respiratory distress. Mean (SD) age of PCR-negative antibody-positive and PCR-positive children was 11 (4.4) and 5 (3.7) years, respectively (P=0.007). The former group had significantly higher mean (SD) D-dimer levels [16,651 (14859) ng/mL vs 3082 (2591) ng/mL; P=0.02]. All received intensive care management and steroid therapy; 7 children received intravenous immunoglobulin. 14 children survived and 3 died.
Conclusions
The outcome of children with MIS-C was good if recognized early and received intensive care.
Keywords: COVID-19, Hypotensive shock, Respiratory distress, Steroids
Acknowledgements
Drs. Najumal Hussain, Anna Simon and Leni Mathew were involved in the clinical care of patients studied. Dr. Grace Rebekah for her help in statistical analysis and Dr. Mahesh Moorthy, Clinical Virology for his help in providing the SARS-CoV-2 PCR and antibody levels.
Footnotes
Ethics clearance
Institutional Research Board, CMC Vellore; No. 13521, dated October 28, 2020.
Contributors
C, EJJ: conception and design, acquisition of data, analysis and interpretation of data; JC, EJJ, VPV, SKT: drafting the article, revising it critically for important intellectual content; JC, EJJ, VPV, SKT, KR, SV: final approval of the version to be submitted and any revised version to be published.
Funding
None
Competing interests
None stated.
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