tetano
Editor, Senior Moderator
Int J Rheum Dis
. 2023 Nov 10.
doi: 10.1111/1756-185X.14970. Online ahead of print. Clinical manifestations and outcomes associated with PICU admission in children with multisystem inflammatory syndrome in Taiwan: A retrospective cohort study
Chi-Teng Tseng[SUP] 1 [/SUP], Jainn-Jim Lin[SUP] 2 3 [/SUP], Jing-Long Huang[SUP] 1 2 4 [/SUP], Cheng-Hsun Chiu[SUP] 2 5 [/SUP], Chao-Yi Wu[SUP] 1 2 [/SUP]
Affiliations
Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare and serious systemic inflammatory disorder that occurs following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to investigate the clinical manifestations, risk factors associated with pediatric intensive care unit (PICU) admission, and outcome among children with MIS-C in Taiwan.
Methods: A retrospective analysis was conducted among pediatric patients diagnosed with MIS-C between June 2022 and February 2023 at Chang Gung Memorial Hospital, Linkou, Taiwan. Data on demographics, clinical features, laboratory findings, treatment modalities, and outcomes were collected and analyzed.
Results: Twenty-eight MIS-C patients, including 9 boys and 19 girls, with an average age of 5.3 ± 3.8 years old, were enrolled. Most of the cases (78.6%) were diagnosed following the first pandemic wave of COVID-19 in Taiwan. The leading clinical manifestations observed were fever (100%), skin rash (64.3%), tachycardia (46.4%), and vomiting (46.4%). Nine patients (32.1%) were admitted to the PICU due to hypotension or neurological manifestations. Higher levels of band-form white blood cells, procalcitonin, ferritin, d-dimer, prothrombin time, NT-proBNP, and lower platelet levels on arrival were associated with PICU admission (p = 3.9 × 10[SUP]-2[/SUP] ,9 × 10[SUP]-3[/SUP] , 4 × 10[SUP]-3[/SUP] ,1 × 10[SUP]-3[/SUP] , 5 × 10[SUP]-3[/SUP] , 4.1 × 10[SUP]-2[/SUP] , and 3.4 × 10[SUP]-2[/SUP] , respectively). Arrhythmia in one case (3.5%) and coronary artery abnormalities, including dilatation in two cases (7.1%) and small aneurysms in one case (3.5%) were identified. Regardless of ICU admission, no patients experienced systolic dysfunction or mortality following treatment.
Conclusion: MIS-C cases in Taiwan have a favorable outcome. Although one-third of the patients required PICU admission, none of the MIS-C cases resulted in severe cardiovascular morbidity or mortality. This study provides valuable insights into the clinical manifestations and outcomes associated with PICU admission in children with MIS-C in Taiwan.
Keywords: COVID-19; MIS-C; SARS-CoV-2; Taiwan; intensive care.
. 2023 Nov 10.
doi: 10.1111/1756-185X.14970. Online ahead of print. Clinical manifestations and outcomes associated with PICU admission in children with multisystem inflammatory syndrome in Taiwan: A retrospective cohort study
Chi-Teng Tseng[SUP] 1 [/SUP], Jainn-Jim Lin[SUP] 2 3 [/SUP], Jing-Long Huang[SUP] 1 2 4 [/SUP], Cheng-Hsun Chiu[SUP] 2 5 [/SUP], Chao-Yi Wu[SUP] 1 2 [/SUP]
Affiliations
- PMID: 37947261
- DOI: 10.1111/1756-185X.14970
Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare and serious systemic inflammatory disorder that occurs following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to investigate the clinical manifestations, risk factors associated with pediatric intensive care unit (PICU) admission, and outcome among children with MIS-C in Taiwan.
Methods: A retrospective analysis was conducted among pediatric patients diagnosed with MIS-C between June 2022 and February 2023 at Chang Gung Memorial Hospital, Linkou, Taiwan. Data on demographics, clinical features, laboratory findings, treatment modalities, and outcomes were collected and analyzed.
Results: Twenty-eight MIS-C patients, including 9 boys and 19 girls, with an average age of 5.3 ± 3.8 years old, were enrolled. Most of the cases (78.6%) were diagnosed following the first pandemic wave of COVID-19 in Taiwan. The leading clinical manifestations observed were fever (100%), skin rash (64.3%), tachycardia (46.4%), and vomiting (46.4%). Nine patients (32.1%) were admitted to the PICU due to hypotension or neurological manifestations. Higher levels of band-form white blood cells, procalcitonin, ferritin, d-dimer, prothrombin time, NT-proBNP, and lower platelet levels on arrival were associated with PICU admission (p = 3.9 × 10[SUP]-2[/SUP] ,9 × 10[SUP]-3[/SUP] , 4 × 10[SUP]-3[/SUP] ,1 × 10[SUP]-3[/SUP] , 5 × 10[SUP]-3[/SUP] , 4.1 × 10[SUP]-2[/SUP] , and 3.4 × 10[SUP]-2[/SUP] , respectively). Arrhythmia in one case (3.5%) and coronary artery abnormalities, including dilatation in two cases (7.1%) and small aneurysms in one case (3.5%) were identified. Regardless of ICU admission, no patients experienced systolic dysfunction or mortality following treatment.
Conclusion: MIS-C cases in Taiwan have a favorable outcome. Although one-third of the patients required PICU admission, none of the MIS-C cases resulted in severe cardiovascular morbidity or mortality. This study provides valuable insights into the clinical manifestations and outcomes associated with PICU admission in children with MIS-C in Taiwan.
Keywords: COVID-19; MIS-C; SARS-CoV-2; Taiwan; intensive care.