Backgrounds:

Although data on the incidence and severity of COVID-19 due to SARS-CoV-2 infection showed more significant disease among adults and the elderly, a clinical manifestation characterized by a multisystem inflammatory syndrome was described in children (MIS-C).

Methods

A retrospective study was conducted between October 2020 and November 2021 and included all children who were diagnosed with MIS-C.

Inclusion criteria: young age, severe cardiovascular or multisystem clinical manifestations, laboratory evidence of inflammation; and laboratory evidence of SARS-CoV-2 infection. A number of 22 children aged 25 days to 15 years were enrolled.

Results:

Altough the first MIS-C casese were reported from London in late April 2020, the first MIS-C case in Brașov was reported almost 6 months later, in October 2020. The majority of cases were reported during 2021 (20 cases).

54% were girls, 63% came from urban area, mean age was 5 years, most patients were younger than 6 years old (72%). Mean hospital stay was 10.3 days.

Most frequent symptoms were: prolonged fever and gastro-intestinal manifestations (85%), common symptoms were sore throat (68%), mucosal manifestations and lymphadenopthies (54%), rash (50%). Other symptoms were respiratory manifestations (41%) and edema (23%).

Laboratory findings were: normal peripheral white blood cells in 72% of patients, decreased lymphocytes in 40%, mean CRP was 14 mg/dl, mean ESR was 77mm/h, mean Fibrinogen was 557mg/dl, mean Albumin was 3mg/dl, high Ferritin values were found in 63%, high D-Dimers in 81%, high Pro-Bnp in 86% and high Troponin levels in 27% of children.

Corticotherapy was used in 21 cases, intravenous immunoglobulin in 20, Aspirin in 10 and low molecular weight heparin in 7 patients.

Antibiotics were administered in all children.

Conclusions/Learning Points:

It is important to increase awareness of physicians about MIS-C.