Sophie Rhys-Evans (United Kingdom)

Imperial College London Paediatric Infectious Disease
I am a medical student currently intercalating at Imperial in Reproductive and Developmental Sciences (iBSc). I first heard about MIS-C in a lecture last year and since then my interest in this rapidly developing area of paediatric infectious disease has grown. I am fortunate to be undertaking my research project under the supervision of Professor Levin and his team, from who I have learnt so much over the past few months. My research aims to propose variables that might distinguish MIS-C from other infectious or inflammatory diseases in children.

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DISTINGUISHING MIS-C FROM OTHER CAUSES OF INFLAMMATORY OR INFECTIOUS DISEASE: AN INTERNATIONAL COLLABORATION FROM THE MULTI-CENTRE DIAMONDS STUDY (ID 1297)

Session Name
1893 - ORAL PRESENTATIONS 02: COVID CLINICAL AND EPIDEMIOLOGY (ID 36)
Lecture Time
10:35 - 10:42
Room
Hall 02
Presenter

Abstract

Background

One of the challenges in the management of Multisystem Inflammatory Syndrome in Children (MIS-C) is early diagnosis, as symptoms are non-specific and clinical features overlap with those of other infectious and inflammatory diseases. In order to establish how well the WHO criteria for a MIS-C diagnosis can distinguish the disorder from other febrile conditions, we compared patients fulfilling the diagnostic criteria for MIS-C to other febrile or inflammatory conditions, including bacterial and viral infections, and previously recognised inflammatory disorders.

Methods

Non-identifiable data was collected as part of the DIAMONDS study, an international consortium recruiting patients with fever and inflammation across 13 countries. Comparative analysis was performed on over 1000 children recruited from 2020 to 2021.

Results

Patients recruited to DIAMONDS were twice as likely to have an inflammatory diagnosis (6.2%) as those in PERFORM (2.8%), a study with similar inclusion and exclusion criteria that recruited children prior to the COVID-19 pandemic. More than half of patients (53%) with inflammatory conditions in DIAMONDS had a history of SARS-CoV-2 infection or exposure. Bacterial infections were identified in some patients fulfilling MIS-C criteria. A wide spectrum of SARS-CoV-2-related inflammation was observed, including patients who did not meet the WHO definition for MIS-C. Further analysis of this data is ongoing.

Conclusions

Early analysis of the DIAMONDS data has shown the impact of the COVID-19 pandemic on the burden of inflammatory conditions in children. There appears to be a wider spectrum of inflammatory diseases associated with SARS-CoV-2 than what has been identified by the current WHO diagnostic criteria. Further analysis of this data will help understand the impact of SARS-CoV-2 exposure on inflammatory disorders, as well as its impact on secondary infections.

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