Retrospective analysis of cases of multisystem inflammatory syndrome associated with COVID-19 infection in children in the Republic of Komi

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a new and relatively rare nosology in children associated with COVID-19 infection, which is characterized by severe multiple organ involvement and poses an immediate life threat.Objective: to analyze the clinical, laboratory and instrumental examination data of patients with MIS-C associated with COVID-19 infection, hospitalized in the Republican Infectious Diseases Hospital of the Komi Republic and the Republican Children's Clinical Hospital of the Ministry of Health of the Komi Republic from April 2020 to April 2022.Material and methods. The retrospective study included 15 patients. The diagnosis was verified according to the Guidelines of the Russian Ministry of Health (version dated July 3, 2020). The results of clinical, instrumental and laboratory examination of patients were evaluated in comparison with literature data.Results and discussion. The prevalence of MIS-C in the Komi Republic was 5.5 per 100,000 persons under 18 years of age. The majority of the study cohort were males (66.7%), the median age was 3 years. 46.7% of cases were between the ages of 8 and 14 years. At the onset of clinical manifestations, all patients had fever and gastrointestinal symptoms. In 80% of children, pathological changes of skin and mucous membranes, as well as respiratory disorders were revealed. Involvement of the cardiovascular system in the pathological process was noted in 66.7% of cases. Less frequently, the urinary tract was affected. When analyzing laboratory data, an increase in the level of inflammatory markers, as well as lymphopenia and neutrophilia, were noted. Most patients received therapy with intravenous immunoglobulin and systemic glucocorticoids, as well as anticoagulants and acetylsalicylic acid. The outcomes of the disease in most cases were favorable, in 6.7% of patients a lethal outcome was recorded.Conclusion. The analysis of cases of MIS-C illustrates the high frequency of seroconversion to the SARS-CoV-2 virus, the predominance of males compared to females (2:1 ratio), the prevalence of the age group under 4 years, the heterogeneity of clinical manifestations and generally favorable prognosis. The diversity of clinical features of COVID-19 warrants a high degree of suspicion for MIS-C, as well as the development of a predictive tool, the "MIS-C Suspicion Index".

Keywords

• multisystem inflammatory syndrome in children
• complication of covid-19
• clinical picture
• treatment.