Table 3.
Clinical outcomes and management of the patients with multisystem inflammatory syndrome in children (MIS‐C) by age groups
| All patients (n = 101) | 0–5 years (n = 29) | 5–12 years (n = 56) | >12 years (n = 16) | P | |
|---|---|---|---|---|---|
| Characteristic | |||||
| ICU admission, n (%) | 38 (37.6) | 9 (31) | 20 (35.7) | 9 (56.2) | 0.235 |
| Duration of ICU median (IQR) | 6 (3.0–9.0) | 7 (3.5–11.0) | 4 (3.0–8.5) | 7 (4.5–8.0) | 0.245 |
| Duration of hospitalisation median (IQR) | 10 (7–14) | 9.5 (7–13.7) | 10 (7.2–13.5) | 10 (7–15) | 0.873 |
| Shock†, n (%) | 39 (38.6) | 6 (20.6) | 25 (44.6) | 8 (50) | 0.059 |
| Cardiac dysfunction, n (%) | 18 (17.8) | 2 (6.8) | 12 (21.4) | 4 (25) | 0.159 |
| Respiratory failure, n (%) | 19 (18.8) | 3 (10.3) | 9 (16) | 7 (43.7) | 0.018 |
| Acute kidney injury‡, n (%) | 18 (17.8) | 3 (10.3) | 8 (14.2) | 7 (43.7) | 0.012 |
| Hematologic failure§, n (%) | 96 (95) | 27 (93.1) | 53 (94.6) | 16 (100) | 0.328 |
| Meets KD or incomplete KD criteria¶, n (%) | 70 (69.3) | 20 (68.9) | 41 (73.2) | 9 (56.2) | 0.430 |
| Pharmacotherapy | |||||
| Intravenous immunoglobulin (IVIG), n (%) | 92 (91%) | 27 (93.1) | 50 (89.2) | 15 (93.7) | 0.775 |
| Corticosteroids, n (%) | 59 (58.4) | 10 (34.4) | 41 (73.2) | 8 (50) | 0.020 |
| Acetylsalicylic acid, n (%) | 51 (50.4) | 18 (62) | 27 (48.2) | 6 (37.5) | 0.253 |
| Anticoagulants, n (%) | 48 (47.5) | 10 (34.4) | 27 (48.2) | 11 (68.7) | 0.087 |
| Oxygen replacement, n (%) | 44 (43.5) | 7 (24.1) | 27 (48.2) | 10 (62.5) | 0.026 |
| Inotropes, n (%) | 28 (27.7) | 5 (17.2) | 17 (30.3) | 6 (37.5) | 0.280 |
| Anakinra, n (%) | 11 (10.8) | 3 (10.3) | 7 (12.5) | 1 (6.2) | ‐ |
| Plasma exchange, n (%) | 7 (6.9) | 1 (3.4) | 3 (5.3) | 3 (18.7) | ‐ |
| Tocilizumab, n (%) | 3 (2.9) | ‐ | 1 (1.7) | 2 (12.5) | ‐ |
| Infliximab, n (%) | 1 (0.9) | 1 (3.4) | ‐ | ‐ | ‐ |
| Outcomes | |||||
| NIMV, n (%) | 16 (15.8) | 3 (10.3) | 8 (14.2) | 5 (31.2) | 0.165 |
| Intubation, n (%) | 11 (10.8) | 3 (10.3) | 5 (8.9) | 3 (18.7) | 0.535 |
| Prone position, n (%) | 5 (4.9) | 1 (3.4) | 2 (3.5) | 2 (12.5) | 0.098 |
| ECMO, n (%) | 2 (1.9) | 1 (3.4) | 1 (1.7) | ‐ | ‐ |
| Coronary artery dilatation patient no./total no. (%) | 19/85 (22.3) | 6/25 (24) | 10/47 (21.2) | 3/13 (23) | 0.963 |
| Coronary artery aneurysm patient no./total no. (%) | 5/85 (8%) | 1/25 (4%) | 4/47 (8.5%) | −/13 | 0.459 |
| Death, n (%) | 7 (6.9%) | 2 (6.8%) | 4 (7.1%) | 1 (6.2%) | ‐ |
Shock was defined as needing inotrope support or fluid resuscitation >20 mL/kg.
Acute kidney injury defined by creatinine level greater than the upper limit for age.
American Heart Association criteria for the definition of KD is to have persistent fever and four of the following five mucocutaneous features: erythema and cracking of lips/strawberry tongue and/or erythema of oral and pharyngeal mucosa; bilateral bulbar conjunctival injection without exudate; rash; erythema and oedema of the hands and feet in acute phase and/or periungual desquamation in subacute phase and cervical lymphadenopathy.
Hematologic failure was defined as D‐dimer elevation and/or neutrophilia and/or lymphopenia. Neutrophilia was defined as ANC ≥7700/μg/L. Lymphopenia was defined as below 4500 μL in children under 8 months of age and below 1500 μL above 8 months of age.
ANC, absolute neutrophil count; ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; IQR, interquartile range; KD, Kawasaki disease; NIMV, non‐invasive mechanical ventilation. Significant p values are indicated in bold.