Determination of Risk Factors for Severe Life-Threatening Course of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children

• Main Authors: Ilia S. Avrusin (Author), Natalia N. Abramova (Author), Konstantin E. Belozerov (Author), Gleb V. Kondratiev (Author), Liudmila V. Bregel (Author), Olesya S. Efremova (Author), Alla A. Vilnits (Author), Julia E. Konstantinova (Author), Eugenia A. Isupova (Author), Tatiana L. Kornishina (Author), Vera V. Masalova (Author), Eugeniy Yu. Felker (Author), Olga V. Kalashnikova (Author), Vyacheslav G. Chasnyk (Author), Yuriy S. Aleksandrovich (Author), Mikhail M. Kostik (Author)
• Format: Book
• Published: MDPI AG, 2023-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a life-threatening condition that often requires intensive care unit (ICU) admission. The aim of this study was to determine risk factors for severe/life-threatening course of MIS-C. The study included 166 patients (99 boys, 67 girls) aged 4 months-17 years (median 8.2 years). The criterion of severity was the fact of ICU admission. To conduct a comparative analysis, MIS-C patients were divided into two groups: patients hospitalized in the ICU (<i>n</i> = 84, 50.6%) and those who did not need ICU admission (<i>n</i> = 82, 49.4%). Patients with a more severe course of MIS-C were significantly older. They had a higher frequency of signs such as rash, swelling, hepatomegaly, splenomegaly, and neurological and respiratory symptoms. Hypotension/shock and myocardial involvement were much more common in patients with severe MIS-C. These patients had a more significant increase in CRP, creatinine, troponin, and D-dimer levels. Additionally, the presence of macrophage activation syndrome was higher in patients admitted to the ICU. Conclusion: Nineteen predictors of severe course of MIS-C were found, out of which hepatomegaly, splenomegaly, D-dimer > 2568 ng/mL, troponin > 10 pg/mL were mainly associated with the probability of being classified as early predictors of severe MIS-C requiring ICU admission.

Item Description

10.3390/children10081366
2227-9067