Predictors of severe illness in children with multisystem inflammatory syndrome after SARS-CoV-2 infection: a multicentre cohort study

• DOI: 10.1503/cmaj.210873
• Publication Date: 2022-04-11T05:20:16Z
• Authors: Joanna Merckx; Suzette Cooke; Tala El Tal; Ari Bitnun; Shaun K. Morris; E. Ann Yeh; Carmen Yea; Peter Gill; Jesse Papenburg; Marie-Astrid Lefe...; Rosie Scuccimarri; Rolando Ulloa-Gut...; Helena Brenes-Chacon; Adriana Yock-Corr...; Gabriela Ivankovi...; Alejandra Soriano...; Marcela Hernandez...; Tammie Dewan; Lea Restivo; Alireza Nateghian; Behzad Haghighi Aski; Ali Manafi; Rachel Dwilow; Jared Bullard; Alison Lopez; Manish Sadarangani; Ashley Roberts; Michelle Barton; Dara Petel; Nicole Le Saux; Jennifer Bowes; Rupeena Purewal; Janell Lautermilch; Sarah Tehseen; Ann Bayliss; Jacqueline K. Wong; Kirk Leifso; Cheryl Foo; Joan Robinson
• Keywords: Male; Canada; SARS-CoV-2; Research; COVID-19; Systemic Inflammatory Response Syndrome; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Child, Preschool; Ferritins; Humans; Child; Connective Tissue Diseases

<h3>Background:</h3> SARS-CoV-2 infection can lead to multisystem inflammatory syndrome in children (MIS-C). We sought investigate risk factors for admission the intensive care unit (ICU) and explored changes disease severity over time. <h3>Methods:</h3> obtained data from chart reviews of younger than 18 years with confirmed or probable MIS-C who were admitted 15 hospitals Canada, Iran Costa Rica between Mar. 1, 2020, 7, 2021. Using multivariable analyses, we evaluated whether date other characteristics associated ICU cardiac involvement. <h3>Results:</h3> Of 232 (median age 5.8 yr), 130 (56.0%) male 50 (21.6%) had comorbidities. Seventy-three (31.5%) patients but none died. observed an increased among aged 13–17 (adjusted difference 27.7%, 95% confidence interval [CI] 8.3% 47.2%), those 6–12 25.2%, CI 13.6% 36.9%) initial ferritin levels greater 500 μg/L 18.4%, 5.6% 31.3%). Children hospital after Oct. 31, numerically higher rates 12.3%, −0.3% 25.0%) significantly involvement 30.9%, 17.3% 44.4%). At Canadian sites, was December 2020 March 2021 May 25.3%, 6.5% 44.0%). <h3>Interpretation:</h3> that more severe MIS-C. later study period. Whether emerging variants pose different risks needs be determined.