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VOLUME 25 , ISSUE 10 ( October, 2021 ) > List of Articles


COVID-19-associated Multisystem Inflammatory Syndrome in Children: A Multicentric Retrospective Cohort Study

Bharat Mehra, Mukul Pandey, Tania Oberoi, Nameet Jerath, Rachna Sharma, Naresh Lal, Chandrasekhar Singha, Bhavana Malhotra, Vinamra Manocha, Ashish K Simalti, Yogesh Arya, Sandeep K Dugaya, Swati Kalra, Amar J Chitkara, Anil Sachdev

Keywords : Corticosteroids, Hyperinflammation, Intravenous Immunoglobulin—IVIG, Kawasaki disease, Multisystem inflammatory syndrome in children (MIS-C), SARS-CoV-2

Citation Information : Mehra B, Pandey M, Oberoi T, Jerath N, Sharma R, Lal N, Singha C, Malhotra B, Manocha V, Simalti AK, Arya Y, Dugaya SK, Kalra S, Chitkara AJ, Sachdev A. COVID-19-associated Multisystem Inflammatory Syndrome in Children: A Multicentric Retrospective Cohort Study. Indian J Crit Care Med 2021; 25 (10):1176-1182.

DOI: 10.5005/jp-journals-10071-23996

License: CC BY-NC 4.0

Published Online: 21-06-2022

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Background: Multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new entity affecting a small percentage of children during the COVID-19 pandemic. Materials and methods: Demography, clinical, and laboratory variables of children admitted from April to September 2020 with MIS-C were studied retrospectively at eight hospitals in Delhi, India. Results: We identified 120 patients [median age: 7 years (interquartile range (IQR): 4–10)] with male-to-female ratio of 2.3:1. Overall, 73 out of 120 children (60.8%) presented with shock, 63 (52.5%) required inopressor support, and 51 (43%) required respiratory support. We categorized the cohort into three observed clinical phenotypes: MIS-C with shock (n = 63), MIS-C with Kawasaki disease (KD) (n = 23), and MIS-C without shock and KD (n = 34). Atypical presentations were hypothermia, orchitis, meningoencephalitis, demyelination, polyneuropathy, pancreatitis, and appendicitis. Ninety-four percent had laboratory evidence of SARS-CoV-2 (78.3%, seropositive and 15.8%, RT-PCR positive). The median C-reactive protein (CRP) was 136 mg/L (IQR, 63.5–212.5) and ferritin was 543 ng/mL (IQR, 225–1,127). More than 90% received immunomodulatory therapy (intravenous immunoglobulins and/or steroids) with an excellent outcome (96% survived). CRP and absolute neutrophil count (ANC) were correlated statistically with severity. Conclusion: MIS-C data from Delhi are presented. Rising CRP and ANC predict the severe MIS-C.

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