Nayak Snehamayee, Panda Prakash Chandra, Biswal Basudev, Agarwalla Sunil Kumar, Satapathy Amit Kumar, Jena Pradeep Kumar, Gulla Krishna Mohan, Rath Debasmita, Mahapatra Anuspandana, Mishra Pravakar, Priyadarshini Debashree, Mahapatro Samarendra, Nayak Saurav, Das Rashmi Ranjan
SCB Medical College, Sardar Vallabhbhai Patel Post Graduate Institute of Paediatrics (SVPPGIP), Cuttack, India.
Department of Pediatrics, Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Sambalpur, India.
Front Pediatr. 2022 Mar 11;10:834039. doi: 10.3389/fped.2022.834039. eCollection 2022.
Few single center studies from resource-poor settings have reported about the epidemiology, clinical feature and outcome of multisystem inflammatory syndrome in children (MIS-C). However, larger data from multi-center studies on the same is lacking including from Indian setting.
This retrospective collaborative study constituted of data collected on MIS-C from five tertiary care teaching hospitals from Eastern India. Children ≤ 15 years of age with MIS-C as per the WHO criteria were included. Primary outcome was mortality.
A total of 134 MIS-C cases were included (median age, 84 months; males constituted 66.7%). Fever was a universal finding. Rash was present in 40%, and conjunctivitis in 71% cases. Gastro-intestinal and respiratory symptoms were observed in 50.7% and 39.6% cases, respectively. Co-morbidity was present in 23.9% cases. Shock at admission was noted in 35%, and 27.38% required mechanical ventilation. Fifteen (11.2%) children died. The coronary abnormalities got normalized during follow-up in all except in one child. Initial choice of immunomodulation had no effect on the outcomes. Presence of underlying co-morbidity, lymphopenia, thrombocytosis, hyponatremia, increased LDH (>300 U/L), and hypoalbuminemia were the factors significantly associated an increased mortality.
MIS-C has myriad of manifestations. Underlying co-morbidity, lymphopenia, thrombocytosis, hyponatremia, increased LDH (>300 U/L), and hypoalbuminemia were associated with an increased mortality. No difference in outcome was noted with either steroid or IVIg or both. Coronary artery abnormalities resolved in nearly all cases.
来自资源匮乏地区的单中心研究很少报道儿童多系统炎症综合征（MIS-C）的流行病学、临床特征和结局。然而，缺乏来自多中心研究的更大规模数据，包括印度地区的数据。
这项回顾性合作研究收集了印度东部五家三级护理教学医院关于MIS-C的数据。纳入符合世界卫生组织标准的15岁及以下MIS-C儿童。主要结局是死亡率。
共纳入134例MIS-C病例（中位年龄84个月；男性占66.7%）。发热是普遍现象。40%的病例出现皮疹，71%的病例出现结膜炎。分别有50.7%和39.6%的病例出现胃肠道和呼吸道症状。23.9%的病例存在合并症。入院时35%的病例出现休克，27.38%的病例需要机械通气。15名（11.2%）儿童死亡。除一名儿童外，所有儿童的冠状动脉异常在随访期间均恢复正常。初始免疫调节选择对结局无影响。存在潜在合并症、淋巴细胞减少、血小板增多、低钠血症、乳酸脱氢酶升高（>300 U/L）和低白蛋白血症是与死亡率增加显著相关的因素。
MIS-C有多种表现。潜在合并症、淋巴细胞减少、血小板增多、低钠血症、乳酸脱氢酶升高（>300 U/L）和低白蛋白血症与死亡率增加相关。使用类固醇或静脉注射免疫球蛋白或两者联合使用，结局无差异。几乎所有病例的冠状动脉异常均得到缓解。
