The Risk Factors for a Sever Disease Course in Multisystem Inflammatory Syndrome in Children Multicenter Retrospective study
2Pediatric Rheumatology Unit, Shaare Zedek Medical Center, Jerusalem, Israel
3Shriners Hospital for Children, Chiago, USA
4Pediatric Department Rheumatology Unit, Technion Faculty of Medicine, Meyer Children's Hospital of Haifa, Haifa, Israel
5Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel
6Carmel Medical Center, Haifa, Technion–Israel Institute of Technology, Haifa
7Kaplan Medical Center, Rehovot, Hebrew University and Hadassa, Jerusalem, Israel
8Israel Pediatric Rheumatology Service, Dana Children's Hospital of Tel Aviv Medical Center, Tel Aviv University, Tel Aviv
9Pediatrics depatrtment B, Saban Pediatric Medical center for Israel, Soroka University Medical Center, Beer Sheva, Israel
10Shamir Medical Center, Sackler School of Medicine Tel-Aviv University
Background: Multisystem Inflammatory Syndrome in Children (MIS- C) associated with COVID-19, presents as a cytokine storm with features of Kawasaki disease. It is characterized by protracted fevers, gastrointestinal, cardiac and neurological symptoms. Laboratory tests are characterized by neutrophilia, lymphopenia, hypoalbuminemia and high inflammatory and myocardial damage markers. Many cases present with shock and require intensive care admission.
Objectives: we aimed to identify predictors for severe clinical course as defined by the need for ionotropic support during admission
Methods: A retrospective multinational cohort study was conducted. Patients with diagnosis of MIS-C from 9 Israeli medical centers and one US medical center (Chicago, IL) were included. Demographic, clinical, laboratory and imaging variables during admission and hospitalization were retrieved. Nominal variables were compared using Pearson’s χ2 test, continuous variables that matched parametric criteria were compared by using Student’s t-test, and ordinal variables and continuous variables that did not match parametric criteria were compared by using Wilcoxon or Mann–Whitney U tests. Statistical significance was set at a p-value of 0.05. Univariate regression model to assess odds ratio (OR) of ionotropic support need during hospitalization was then made for each parameter.
Results: Overall 100 MIS-C patients were included in the study. MIS-C was more common in male patients (61.2%) and the mean age at presentation was 9.65±4.48 years. Almost two thirds (65%) were hypotensive, and 44% required ionotropic support. Only 11% of patients fulfilled the Kawasaki disease criteria and 87% had GI