Clinical Profile and Outcome of COVID-Multisystem Inflammatory Syndrome in Children: A Single Centre Retrospective Study

Abstract: Introduction: Multisystem inflammatory syndrome in children (MIS-C) linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a serious delayed hyperinflammatory illness in children and adolescents that manifests 2–6 weeks following prior SARS-CoV-2 infection. Objectives: To study the clinical profile and outcome of children aged 1 month to less than 18 years of age diagnosed with MIS-C. Method: This was a single centre retrospective study between January 2020 and March 2022. Seventy-eight children were selected as per inclusion criteria. Demographic characteristics, clinical manifestations, vital signs, laboratory parameters, radiological investigations, echocardiography at admission, treatment patterns during hospital stay, clinical outcome at discharge and follow-up details were collected and analysed. Results: Of the 78 children studied, children aged 1 month to 6 years were most affected. Median (IQR) age was 4 (2, 9) years with 53.8% females. Fever was noted in 100% children, generalized body pain in 68 (87.2%) and conjunctival congestion in 14 (17.9%) children. Creactive protein (CRP) and erythrocyte sedimentation rate (ESR) were elevated in 77 (98.7%) and 74 (96.1%) children respectively and positive correlation was noted between the two parameters. Coronary artery abnormalities were noted in 17 (21.7%) children. Twentyeight (35.9%) children received steroids with antibiotics. Children with elevated D-dimer had a prolonged hospital stay (p=0.01). While 74 (94.8%) children completely recovered, one (1.3%) child succumbed. Conclusions: Overall course of children with MIS-C was favourable with most children recovering completely after the acute phase and less than one-fourth having significant echocardiographic findings requiring follow-up at a later date.