Clinical spectrum and prognostic markers of multi-system inflammatory syndrome in children hospitalised in Northern India

• DOI: 10.1016/j.cegh.2023.101357
• Publication Date: 2023-07-13T03:29:04Z
• Authors: Areesha Alam; Nishant Verma; Shally Awasthi; Dipti Agarwal; Krishna Kumar Yadav; Pradeep Kumar Gupta; Ranjeeta Dadoria; Anita Mehta; Kuldeep Singh; Moinak Sen Sarma; Amita Aggarwal; Banani Poddar; Vijay jaiswal; Anupama Verma; Sangita Singhal; Bipin Puri
• Keywords: Univariate analysis; Prothrombin time

BackgroundMulti-system inflammatory syndrome in children (MIS-C) is characterized by hyper-inflammation and multi-organ dysfunction with antecedent SARS-CoV-2 infection. To describe clinical, laboratory characteristics outcome of MIS-C a low-middle-income-country to evaluate factors associated mortality.MethodsCases (<18 years) fulfilling WHO case-definition from 7 hospitals Northern-India were included. Clinical, treatment variables compared between survivors non-survivors using univariate analysis. Logistic regression analysis was performed identify their independent association mortality Model 1: clinical parameters 2: parameters.ResultsFrom May October 2021, 98 enrolled mean age (SD) 79 months (54.2) male preponderance (68.4%). Median (IQR) duration diagnosis 6 (4–9) days. Clinical features included fever (100%), gastrointestinal manifestations (70.4%), rash (62.2%), non-purulent conjunctivitis (40.8%) inflammation oral-mucosa (32.7%) extremities (31.6%). Shock noted 40%, myocardial 39% coagulopathy 98.9% cases. Seventy five (76.5%) required ICU admission 16.3% Mechanical ventilation (MV). Mortality rate 18.4%. model 1 identified C - reactive protein (CRP) > 50 mg/L [aOR 9.6 (95% CI 1.8–50.9)] Prothrombin Time (PT) 17 s at presentation 13.6 1.6–118.9)] be independently mortality. Need MV emerged as predictor on 2.ConclusionsChildren having high CRP PT are increased odds dying require intensive monitoring.