Medical Journal of Dr. D.Y. Patil Vidyapeeth (Jan 2022)

Clinical profile and outcome of pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 series in Eastern India

  • Bonny Sen,
  • Mihir Sarkar,
  • Dibyendu Raychaudhuri,
  • Priyankar Pal,
  • Satyabrata Roychowdhoury,
  • Amitabha Chattopadhyay,
  • Avijit Hazra,
  • Rakesh Mondal

DOI
https://doi.org/10.4103/mjdrdypu.mjdrdypu_15_21
Journal volume & issue
Vol. 15, no. 8
pp. 210 – 214

Abstract

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Objective: The objective of this study is to delineate the characteristics and outcome of Pediatric Inflammatory Multisystem Syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARSCoV2) infection (PIMS-TS) in Eastern Indian settings. Materials and Methods: We conducted a prospective observational multicentric study from May 2020 to August 2020, collecting data on clinical profile, investigation findings, and outcome of the children aged 1 month–12 years admitted with the features of coronavirus disease 2019 (COVID-19) related hyperinflammation satisfying criteria for PIMS-TS from three tertiary care hospitals of Kolkata. Results: A total of 38 patients fulfilling the criteria of PIMS-TS were recruited. The median age of the study population was 5 years (1.9–8 years). Gastrointestinal symptoms were present in 33 (86.6%) of patients. Nasopharyngeal swab for COVID-19 reverse transcriptase-polymerase chain reaction was positive in 19 (50%) of patients, and immunoglobulin G antibody against COVID-19 was found in 12 (66.6%) of patients, whereas 19 (50%) of patients had a positive contact history of SARS-Co-V2 exposure. The features of Kawasaki, like illness with coronary changes, were seen in 12 (32%) cases, whereas myocarditis with ejection fraction <55% was reported in 17 (45%) of patients. Intensive care admissions were needed in 27 (71%) patients, and inotropes were given in 18 (47%), whereas four patients required mechanical ventilator support. Immunotherapy was used in 32 (84%) of patients. The outcome was good, with one death. Conclusions: PIMS TS has varied clinical presentation ranging from milder cases to severe cardiac dysfunction with shock. However, timely intervention and prompt initiation of immunomodulators can improve the prognosis.

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