Table 1.
COVID-19–Related MIS-A Criteria and SARS-CoV-2 Tests Results
| All Patients (N = 38) | MIS-A− (n = 13) | MIS-A+ (n = 25) | P Value | |
|---|---|---|---|---|
| Age, y | 27.5 (19.0-37.0) | 33.0 (21.5-38.5) | 25.0 (18.5-35.5) | 0.3 |
| Women | 13 (34) | 6 (46) | 7 (28) | 0.3 |
| BMI, kg/m2 | 24.8 (22.4-28.6) | 25.9 (23.3-28.9) | 24.7 (21.7-28.2) | 0.7 |
| Time from first COVID-19 symptoms to myocarditis, days | 5 (0-26) | 3 (0-5) | 8 (2-38) | 0.04 |
| Time from myocarditis symptoms onset to ICU, days | 3 (0-5) | 1 (0-3) | 4 (1-6) | 0.009 |
| ICU admission SOFA score | 8 (5-11) | 11 (8-13) | 6 (4-10) | 0.002 |
| ICU admission SAPS-II score | 30 (20-40) | 33 (25-49) | 25 (15-35) | 0.04 |
| MIS-A criteriaa | ||||
| Fever | 36 (95) | 9 (69) | 25 (100) | 0.01 |
| Primary clinical criteria | ||||
| Myocardial involvement | 38 (100) | 13 (100) | 25 (100) | na |
| Skin involvement | 14 (37) | 1 (8) | 13 (52) | 0.01 |
| Secondary clinical criteria | ||||
| Neurological involvement | 14 (37) | 4 (31) | 10 (40) | 0.5 |
| Shock or hypotension | 36 (95) | 13 (100) | 23 (92) | 0.1 |
| Abdominal involvement | 22 (58) | 7 (54) | 15 (60) | 0.7 |
| Platelets <150 × 109/L | 10 (26) | 5 (38) | 5 (20) | 0.09 |
| Laboratory evidence | ||||
| Inflammationb | 29 (76) | 2 (15) | 25 (100) | <0.0001 |
| Positive SARS-CoV-2 testc | 38 (100) | 13 (100) | 25 (100) | na |
| SARS-CoV-2 tests | ||||
| Positive nasopharyngeal RT-PCR | 14 (37) | 11 (85) | 4 (16) | <0.0001 |
| CT value | 26 (18-32) | 24 (18-28) | 32 (21-34) | 0.2 |
| Positive serology | 26 (68) | 2 (15) | 24 (96) | <0.0001 |
| IgG anti-S | 25 (67) | 2 (15) | 23/24 (96) | <0.0001 |
| Titer, UA/mL | 660 (156-1,440) | 2.3 (0.1-59) | 854 (528-2,575) | <0.0001 |
| IgG anti-N | 26 (68) | 2 (15) | 24 (96) | <0.0001 |
| Index, value | 2.2 (0.1-5.3) | 0.4 (0.03-0.8) | 4.8 (2.2-5.5) | <0.0001 |
Values are median (IQR) or n (%). Continuous variables are compared with Wilcoxon’s rank test; categorical variables are compared with Fisher exact test.
BMI = body mass index; CT = cycle threshold; ICU = intensive care unit; IgG = immunoglobulin G; MIS-A = multisystem inflammatory syndrome in adults; N = nucleocapsid protein; RT-PCR = reverse transcription polymerase-chain reaction; S = spike protein; SAPS-II = Simplified Acute Physiology Score-II; SARS-CoV-2 = severe acute respiratory syndrome-coronavirus-2; SOFA = Sequential Organ Failure Assessment.
According the Centers for Disease Control and Prevention.
Elevated levels of at least 2 of the following biomarkers including: C-reactive protein >10 mg/L, procalcitonin >1 ng/mL, fibrinogen >5 g/L.
Positive RT-PCR, serology, or antigen for SARS-CoV-2.