Frontiers in Pediatrics (May 2022)

Characteristics and Outcomes of Cases of Children and Adolescents With Pediatric Inflammatory Multisystem Syndrome in a Tertiary Care Center in Mexico City

  • Ricardo Gil Guevara,
  • María de Lourdes Marroquín Yáñez,
  • Rodolfo Norberto Jiménez-Juárez,
  • Rodolfo Norberto Jiménez-Juárez,
  • Víctor Olivar Lopez,
  • Adrián Chávez Lopez,
  • Juan José Luis Sienra Monge,
  • Lourdes Maria del Carmen Jamaica Balderas,
  • Silvia Alexandra Martínez Herrera,
  • Clemen Domínguez-Barrera,
  • Julio Erdmenger Orellana,
  • Horacio Márquez González,
  • Miguel Klünder-Klünder,
  • Jaime Nieto Zermeño,
  • Mónica Villa Guillen,
  • Nadia González García,
  • Maria F. Castilla-Peon

DOI
https://doi.org/10.3389/fped.2022.849388
Journal volume & issue
Vol. 10

Abstract

Read online

BackgroundPediatric inflammatory multisystem syndrome (PIMS) is a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children that resembles Kawasaki syndrome and places them at high risk of cardiorespiratory instability and/or cardiac damage. This study aims to describe the clinical presentation and outcomes of patients with PIMS in Mexico City.MethodsThis was an observational study of children hospitalized for PIMS based on the Centers for Disease Control and Prevention case definition criteria, in a single tertiary care pediatric center in Mexico City between May 1, 2020, and September 30, 2021. Demographic characteristics, epidemiological data, medical history, laboratory tests, cardiologic evaluations, treatment, and clinical outcomes were analyzed.ResultsSeventy-five cases fulfilled the case definition criteria for PIMS [median age: 10.9 years, Interquartile range (IQR): 5.6–15.6]. Fifteen (20%) patients had a severe underlying disease, 48 (64%) were admitted to the intensive care unit, 33 (44%) required invasive mechanical ventilation and 39 (52%) received vasopressor support. The patients were clustered through latent class analysis based on identified symptoms: Cluster 1 had rash or gastrointestinal symptoms (n = 60) and cluster 2 were those with predominantly respiratory manifestations (n = 15). Two patients (2.7%) died, and both had severe underlying conditions. Five patients (6.7%), all from cluster 1, developed coronary aneurysms.ConclusionThere were a high proportion of patients with severe respiratory involvement and positive RT-PCR SARS-CoV-2 and very few cases of coronary aneurysms in our study which suggests that a high proportion of the children had severe acute COVID-19. The clinical manifestations and outcomes are comparable to previously reported international studies.

Keywords