Abstract
Objective
To differentiate severe/critical coronavirus disease 2019 (COVID-19) infection from multisystem inflammatory syndrome in children (MIS-C).
Methods
Single-center chart review comparing characteristics of children with MIS-C and ‘severe/critical’ COVID-19 infection. Multivariate logistic regression was performed to create predictive models for predicting MIS-C.
Results
Of 68 patients, 28 (41.2%) had MIS-C while 40 (58.8%) had severe/critical COVID-19 infection. MIS-C patients had a higher prevalence of fever, mucocutaneous, cardiac and gastrointestinal involvement and a lower prevalence of respiratory symptoms (P<0.05). Significantly lower hemoglobin, platelet count, serum electrolytes, and significantly elevated inflammatory and coagulation markers were observed in MIS-C cohort. Upon multivariate logistic regression, the best model included C-reactive protein (CRP), platelet count, gastrointestinal and mucocutaneus involvement and absence of respiratory involvement (performance of 0.94). CRP>40 mg/L with either platelet count <150×109 or mucocutaneous involvement had specificity of 97.5% to diagnose MIS-C.
Conclusion
Elevated CRP, thrombocytopenia and mucocutaneous involvement at presentation are helpful in differentiating MIS-C from severe COVID-19.
Electronic Supplementary Material
Supplementary material is available for this article at 10.1007/s13312-022-2442-4 and is accessible for authorized users.
Keywords: C-reactive protein, Comorbidity, Platelet count, SARS-CoV-2
Electronic supplementary material
Web Table I Multivariate Regression Showing Performances of Various Models to Distinguish MIS-C from Severe/Critical COVID-19 Infection at Presentation
Contributors: NG: conceptualized and designed the study, did data collection, drafted the initial manuscript; ST: carried out the initial analyses, reviewed and revised the manuscript. Both authors approved the final manuscript as submitted.
Funding: None
Ethics clearance: University of Oklahoma Institutional Review Board; No. 12928 dated December 31, 2020.
Competing interests: None stated.
Footnotes
Note: Additional material related to this study is available with the online version at https://www.indianpediatrics.net
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Supplementary Materials
Web Table I Multivariate Regression Showing Performances of Various Models to Distinguish MIS-C from Severe/Critical COVID-19 Infection at Presentation