Backgrounds:

COVID-19 infection is usually mild in children. However, a multisystem inflammatory syndrome (MISC) can happen, 4-6 weeks post infection mainly in school-age children. While uncommon it can be lifetreatening and intensive care treatment may be needed.

Methods

We present three children with MISC entered in our unit during 2020-21, a 7 bed multidisciplinary PICU in a tertiary University Hospital, where children and adolescents from all the southern part of our country are admitted. Characteristics, demographical, clinical profile, clinical course, laboratory results, duration of mechanical ventilation and hospitalization, therapy and outcome were recorded.

Results:

All were girls, 6, 7 and 16 years old respectively and had no comorbidities except of autoimmunity in the 6 years old female’s family. All reported a contact with a COVID-19 case, and the 16 years old girl had a recent (1 month before) self test positive for SARS-CoV-2 infection, without symptoms. None confirmed by RT-PCR and/or serology. All need inotropic and vasoactive support for severe cardiovascular compromise. Lymphocyte count, neutrophil count, C-reactive protein, procalcitonin, ferritin, d-Dimer and cardiac dysfunction markers were increased. Treatment included antibiotics, corticosteroids and IVIG and enoxaparin. Two needed invasive mechanical ventilation, the 7 years old girl for 23 days and the 6 years old for 5 days. Median length of PICU stay was 16 days (28,13,7 respectively) None death occurred All survived and quitted PICU in good clinical condition.

Conclusions/Learning Points:

MISC represents a serious condition relating to Covid infection and propably a main couse of hospitalization or PICU admission. MIS-C can be a treatable condition with intensive care therapy.

Long-term multidisciplinary follow-up may be necessary to ensure if chronic cardiac impairment or other dysfunctions remain.

ΒΙΒΛΙΟΓΡΑΦΙΑ

https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-clinical-features-evaluation-and-diagnosis

World J Pediatr. 2022 Jan 4:1-8