Characteristics of COVID-19-associated multisystemic inflammatory syndrome in children treated in a peruvian hospital, 2020-2022
DOI:
https://doi.org/10.17843/rpmesp.2024.413.13736Keywords:
COVID-19, SARS-CoV-2, Multisystem Inflammatory Syndrome in Children, Kawasaki Disease, Intravenous ImmunoglobulinAbstract
This study aimed to describe the characteristics of multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) in the first three years of the pandemic in children in a pediatric hospital in Peru. We conducted an observational, descriptive study with data from 73 patients and described the clinical and laboratory characteristics, treatment and complications according to the wave of the pandemic and whether they had shock. The median age was 6 years, gastrointestinal and mucocutaneous manifestations were frequent in the three waves. Kawasaki disease-like phenotype was present in 34 (46.6%) patients and 21 (28.8%) patients developed shock. The most commonly used treatment was immunoglobulin (95.9%), followed by acetylsalicylic acid (94.5%) and corticosteroid (86.3%). Five (7%) patients had coronary aneurysm and 17 (23.3%) were admitted to the intensive care unit (ICU). Patients with shock had greater laboratorial alteration and need for mechanical ventilation. In conclusion, MIS-C has decreased in the first three years of the pandemic, possibly due to COVID-19 vaccination in children.
Downloads
References
Jiang L, Tang K, Levin M, Irfan O, Morris SK, Wilson K, et al. COVID-19 and multisystem inflammatory syndrome in children and
adolescents. Lancet Infect Dis. 2020;20(11):e276-88. doi: 10.1016/S1473-3099(20)30651-4.
Payne AB, Gilani Z, Godfred-Cato S, Belay ED, Feldstein LR, Patel MM, et al. Incidence of Multisystem Inflammatory Syndrome in Children Among US Persons Infected With SARS-CoV-2. JAMA Netw Open. 2021;4(6):e2116420. doi: 10.1001/jamanetworkopen.2021.16420.
Ruvinsky S, Voto C, Roel M, Fustiñana A, Veliz N, Brizuela M, et al. Multisystem Inflammatory Syndrome Temporally Related to
COVID-19 in Children From Latin America and the Caribbean Region: A Systematic Review With a Meta-Analysis of Data From
Regional Surveillance Systems. Front Pediatr. 2022;10:881765. doi: 10.3389/fped.2022.881765.
Buonsenso D, Perramon A, Català M, Torres JP, Camacho-Moreno G, Rojas-Solano M, et al. Multisystemic Inflammatory Syndrome in Children in Western Countries: Decreasing Incidence as the Pandemic Progresses?: An Observational Multicenter International Cross-sectional Study. Pediatr Infect Dis J. 2022;41(12):989-993 doi: 10.1097/INF.0000000000003713.
Holm M, Espenhain L, Glenthøj J, Schmidt LS, Nordly SB, Hartling UB, et al. Risk and Phenotype of Multisystem Inflammatory Syndrome in Vaccinated and Unvaccinated Danish Children Before and During the Omicron Wave. JAMA Pediatr. 2022;176(8):821-3. doi:
1001/jamapediatrics.2022.2206.
Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P, et al. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020;324(3):259-69. doi: 10.1001/jama.2020.10369.
Pérez-Gómez HR, Morfín-Otero R, González-Díaz E, Esparza-Ahumada S, León-Garnica G, Rodríguez-Noriega E. The Multifaceted Manifestations of Multisystem Inflammatory Syndrome during the SARS-CoV-2 Pandemic. Pathogens. 2022;11(5):556. doi: 10.3390/pathogens11050556.
Godfred-Cato S, Abrams JY, Balachandran N, Jaggi P, Jones K, Rostad CA, et al. Distinguishing Multisystem Inflammatory Syndrome in Children From COVID-19, Kawasaki Disease and Toxic Shock Syndrome. Pediatr Infect Dis J. 2022;41(4):315-23. doi: 10.1097/INF.0000000000003449.
Acevedo L, Piñeres-Olave BE, Niño-Serna LF, Vega LM, Gomez IJA, Chacón S, et al. Mortality and clinical characteristics of multisystem
inflammatory syndrome in children (MIS-C) associated with covid-19 in critically ill patients: an observational multicenter study (MISCO study). BMC Pediatr. 2021;21(1):516. doi: 10.1186/s12887-021-02974-9.
Fernández-Sarmiento J, Acevedo L, Niño-Serna LF, Boza R, García-Silva J, Yock-Corrales A, et al. Risk Factors Associated with Intensive Care Admission in Children with Severe Acute Respiratory Syndrome Coronavirus 2-Related Multisystem Inflammatory Syndrome (MIS-C) in Latin America: A Multicenter Observational Study of the REKAMLATINA Network. J Intensive Care Med. 2024;08850666241233189. doi: 10.1177/08850666241233189.
Jain PN, Acosta S, Annapragada A, Checchia PA, Moreira A, Muscal E, et al. Comparison of Laboratory and Hemodynamic Time Series
Data Across Original, Alpha, and Delta Variants in Patients With Multisystem Inflammatory Syndrome in Children. Pediatr Crit Care Med.
;23(8):e372. doi: 10.1097/PCC.0000000000002976.
Kechiche R, Borocco C, Bajolle F, Belot A, Poignant S, Lachaume N, et al. Multisystem inflammatory syndrome in children during the COVID-19 waves: data from the Juvenile Inflammatory Rheumatism cohort. Front Pediatr. 2023, 24;11:1126985. doi: 10.3389/fped.2023.1126985.
Angurana SK, Kumar V, Nallasamy K, Kumar MR, Naganur S, Kumar M, et al. Clinico-Laboratory Profile, Intensive Care Needs and Short-Term Outcome of Multisystem Inflammatory Syndrome in Children (MIS-C): Experience during First and Second Waves from North India. J Trop Pediatr. 2022;68(5):fmac068. doi: 10.1093/tropej/fmac068.
Gentile A, Juárez MDV, Romero Bollon L, Aprea V, Matteucci E, Falaschi A, et al. Comparison of Epidemiologic and Clinical COVID-19 Profiles in Children in Argentina, During Circulation of Original and Variant (Alpha, Gamma and Lambda) Strains. Pediatr Infect Dis J. 2023;42(2):136. doi: 10.1097/INF.0000000000003776.
Ensinck G, Gregorio G, Flores RM, Crowe CI, Clerico Mosina P, Curi C, et al. Consensus on treatment of multisystemic inflammatory syndrome associated with COVID-19. Arch Argent Pediatr. 2021;119(4):S198-211. doi: 10.5546/aap.2021.S198.
Atamari-Anahui N, Ccorahua-Rios MS, Rodriguez-Camino MC, Santander-Cahuantico AC, Pacheco-Mendoza J. Bibliometric Analysis
of Scientific Production in Scopus by the Instituto Nacional de Salud Del Niño-Breña, Peru, 2010–2019. Journal of Hospital Librarianship.
;22(2):108-20. doi: 10.1080/15323269.2022.2054601.
Izquierdo G, Cofré F, Poli C, Delpiano L, Conca N, Verdugo P, et al. Recomendaciones para la sospecha diagnóstica y manejo del Síndrome Inflamatorio Multisistémico (SIM-COVID-19) en contexto pandemia SARS-CoV-2. Abril 2021. Rev Chil Infectol. 2021;38(3):370-80. doi: 10.4067/S0716-10182021000300370.
Alvarado-Gamarra G, Aguila O del, Dominguez-Rojas J, Chonlon-Murillo K, Atamari-Anahui N, Borcic A, et al. Fenotipos clínicos del síndrome inflamatorio multisistémico pediátrico asociado a COVID-19 (SIM-C). Andes Pediatr. 2022;93(6):841-50. doi: 10.32641/andespediatr.v93i6.4084.
Araujo-Castillo R. Dos años de pandemia, una batalla que aún no termina. Acta Médica Peru. 2022;39(1):3-6. doi: 10.35663/amp.2022.391.2374.
Coll-Vela LED, Zamudio-Aquise MK, Nuñez-Paucar H, Bernal-Mancilla RR, Schult-Montoya SC, Ccorahua-De La Paz M, et al. Síndrome inflamatorio multisistémico asociado a COVID-19 en niños: serie de casos en un hospital pediátrico de Perú. Rev Peru Med Exp Salud Publica. 2020;37(3):559-65. doi: 10.17843/rpmesp.2020.373.6126.
Zambrano LD, Newhams MM, Olson SM, Halasa NB, Price AM, Boom JA, et al. Effectiveness of BNT162b2 (Pfizer-BioNTech)
mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12-18 Years - United States, July-December 2021. MMWR Morb Mortal Wkly Rep. 2022;71(2):52-8. doi: 10.15585/mmwr.mm7102e1.
McCrindle Brian W, Rowley Anne H, Newburger Jane W, Burns Jane C, Bolger AF, Gewitz M, et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation. 2017;135(17):e927-99. doi: 10.1161/CIR.0000000000000484.
McArdle AJ, Vito O, Patel H, Seaby EG, Shah P, Wilson C, et al. Treatment of Multisystem Inflammatory Syndrome in Children. N Engl J Med. 2021;385(1):11-22. doi: 10.1056/NEJMoa2102968.
Son MBF, Murray N, Friedman K, Young CC, Newhams MM, Feldstein LR, et al. Multisystem Inflammatory Syndrome in Children - Initial Therapy and Outcomes. N Engl J Med. 2021;385(1):23-34. doi: 10.1056/NEJMoa2102605.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Cynthia Huby-Muñoz, Claudia Peña-Coello, Deli Guillen-Buleje, Luis Gomez-Martinez, Héctor Nuñez-Paucar, Mariela Zamudio-Aquise, Raúl Bernal-Mancilla, Liz De Coll-Vela, Carlos Orellana-Siuce, Jorge Candela-Herrera, Noé Atamari-Anahui
This work is licensed under a Creative Commons Attribution 4.0 International License.