tetano
Editor, Senior Moderator
Sci Rep
. 2024 Jul 9;14(1):15810.
doi: 10.1038/s41598-024-66891-4. Severity predictors for multisystemic inflammatory syndrome in children after SARS-CoV-2 infection in Vietnam
Dien M Tran[SUP] 1 2 [/SUP], Dem V Pham[SUP] 2 [/SUP], Tung V Cao[SUP] 3 [/SUP], Canh N Hoang[SUP] 4 [/SUP], Ha T T Nguyen[SUP] 5 [/SUP], Giang D Nguyen[SUP] 5 [/SUP], Cuong N Le[SUP] 4 [/SUP], Quan Q Thieu[SUP] 4 [/SUP], Tuan A Ta[SUP] 4 [/SUP], Hung V Dau[SUP] 4 [/SUP], Chi Q Le[SUP] 5 [/SUP], Quang H Le[SUP] 3 [/SUP], Nghiem T Luong[SUP] 6 [/SUP], Mai T Tran[SUP] 7 [/SUP], Phu H Nguyen[SUP] 8 [/SUP], Nhung T Nguyen[SUP] 8 9 [/SUP], Phuc H Phan[SUP] 10 11 [/SUP]
Affiliations
Multisystemic inflammatory syndrome in children (MIS-C) might manifest in a broad spectrum of clinical scenarios, ranging from mild features to multi-organ dysfunction and mortality. However, this novel entity has a heterogenicity of data regarding prognostic factors associated with severe outcomes. The present study aimed to identify independent predictors for severity by using multivariate regression models. A total of 391 patients (255 boys and 136 girls) were admitted to Vietnam National Children's Hospital from January 2022 to June 2023. The median age was 85 (range: 2-188) months, and only 12 (3.1%) patients had comorbidities. 161 (41.2%) patients required PICU admission, and the median PICU LOS was 4 (2-7) days. We observed independent factors related to PICU admission, including CRP ≥
50 (mg/L) (OR 2.52, 95% CI 1.39-4.56, p = 0.002), albumin ≤ 30 (g/L) (OR 3.18, 95% CI 1.63-6.02, p = 0.001), absolute lymphocyte count ≤ 2 (× 10[SUP]9[/SUP]/L) (OR 2.18, 95% CI 1.29-3.71, p = 0.004), ferritin ≥ 300 (ng/mL) (OR 2.35, 95% CI 1.38-4.01), p = 0.002), and LVEF < 60 (%) (OR 2.48, 95% CI 1.28-4.78, p = 0.007). Shock developed in 140 (35.8%) patients, especially for those decreased absolute lymphocyte ≤ 2 (× 10[SUP]9[/SUP]/L) (OR 2.48, 95% CI 1.10-5.61, p = 0.029), albumin ≤ 30 (g/L) (OR 2.53, 95% CI 1.22-5.24, p = 0.013), or LVEF < 60 (%) (OR 2.24, 95% CI 1.12-4.51, p = 0.022). In conclusion, our study emphasized that absolute lymphocyte count, serum albumin, CRP, and LVEF were independent predictors for MIS-C severity. Further well-designed investigations are required to validate their efficacy in predicting MIS-C severe cases, especially compared to other parameters. As MIS-C is a new entity and severe courses may progress aggressively, identifying high-risk patients optimizes clinicians' follow-up and management to improve disease outcomes.
Keywords: MIS-C; Multisystemic inflammatory syndrome in children; SARS-CoV-2; Severity; Shock.
. 2024 Jul 9;14(1):15810.
doi: 10.1038/s41598-024-66891-4. Severity predictors for multisystemic inflammatory syndrome in children after SARS-CoV-2 infection in Vietnam
Dien M Tran[SUP] 1 2 [/SUP], Dem V Pham[SUP] 2 [/SUP], Tung V Cao[SUP] 3 [/SUP], Canh N Hoang[SUP] 4 [/SUP], Ha T T Nguyen[SUP] 5 [/SUP], Giang D Nguyen[SUP] 5 [/SUP], Cuong N Le[SUP] 4 [/SUP], Quan Q Thieu[SUP] 4 [/SUP], Tuan A Ta[SUP] 4 [/SUP], Hung V Dau[SUP] 4 [/SUP], Chi Q Le[SUP] 5 [/SUP], Quang H Le[SUP] 3 [/SUP], Nghiem T Luong[SUP] 6 [/SUP], Mai T Tran[SUP] 7 [/SUP], Phu H Nguyen[SUP] 8 [/SUP], Nhung T Nguyen[SUP] 8 9 [/SUP], Phuc H Phan[SUP] 10 11 [/SUP]
Affiliations
- PMID: 38982132
- PMCID: PMC11233495
- DOI: 10.1038/s41598-024-66891-4
Multisystemic inflammatory syndrome in children (MIS-C) might manifest in a broad spectrum of clinical scenarios, ranging from mild features to multi-organ dysfunction and mortality. However, this novel entity has a heterogenicity of data regarding prognostic factors associated with severe outcomes. The present study aimed to identify independent predictors for severity by using multivariate regression models. A total of 391 patients (255 boys and 136 girls) were admitted to Vietnam National Children's Hospital from January 2022 to June 2023. The median age was 85 (range: 2-188) months, and only 12 (3.1%) patients had comorbidities. 161 (41.2%) patients required PICU admission, and the median PICU LOS was 4 (2-7) days. We observed independent factors related to PICU admission, including CRP ≥
50 (mg/L) (OR 2.52, 95% CI 1.39-4.56, p = 0.002), albumin ≤ 30 (g/L) (OR 3.18, 95% CI 1.63-6.02, p = 0.001), absolute lymphocyte count ≤ 2 (× 10[SUP]9[/SUP]/L) (OR 2.18, 95% CI 1.29-3.71, p = 0.004), ferritin ≥ 300 (ng/mL) (OR 2.35, 95% CI 1.38-4.01), p = 0.002), and LVEF < 60 (%) (OR 2.48, 95% CI 1.28-4.78, p = 0.007). Shock developed in 140 (35.8%) patients, especially for those decreased absolute lymphocyte ≤ 2 (× 10[SUP]9[/SUP]/L) (OR 2.48, 95% CI 1.10-5.61, p = 0.029), albumin ≤ 30 (g/L) (OR 2.53, 95% CI 1.22-5.24, p = 0.013), or LVEF < 60 (%) (OR 2.24, 95% CI 1.12-4.51, p = 0.022). In conclusion, our study emphasized that absolute lymphocyte count, serum albumin, CRP, and LVEF were independent predictors for MIS-C severity. Further well-designed investigations are required to validate their efficacy in predicting MIS-C severe cases, especially compared to other parameters. As MIS-C is a new entity and severe courses may progress aggressively, identifying high-risk patients optimizes clinicians' follow-up and management to improve disease outcomes.
Keywords: MIS-C; Multisystemic inflammatory syndrome in children; SARS-CoV-2; Severity; Shock.