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    Multisystem inflammatory syndrome (MIS-C) in Pakistani children: A description of the phenotypes and comparison with historical cohorts of children with Kawasaki disease and myocarditis

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    Author
    Mohsin, Shazia S
    Abbas, Qalab
    Chowdhary, Devyani
    Khalid, Farah
    Sheikh, Abdul Sattar
    Ali Khan, Zuviya Ghazala
    Aslam, Nadeem
    Bhatti, Omaima Anis
    Inam, Maha
    Saleem, Ali Faisal
    Bhutta, Adnan T
    Show allShow less

    Date
    2021-06-21
    Journal
    PLoS ONE
    Publisher
    Public Library of Science
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1371/journal.pone.0253625
    Abstract
    Objectives: To determine clinical, laboratory features and outcomes of Multisystem Inflammatory Syndrome in children (MIS-C) and its comparison with historic Kawasaki Disease (KD) and Viral Myocarditis (VM) cohorts. Methods: All children (1 month- 18 years) who fulfilled the World Health Organization criteria of MIS-C presenting to two tertiary care centers in Karachi from May 2020 till August 31st were included. KD and VM admitted to one of the study centers in the last five years prior to this pandemic, was compared to MIS-C. Results: Thirty children with median age of 24 (interquartile range (IQR)1-192) months met the criteria for MIS-C. Three phenotypes were identified, 12 patients (40%) with KD, ten (33%) VM and eight (26%) had features of TSS. Echocardiography showed coronary involvement in 10 (33%), and moderate to severe Left Ventricular dysfunction in 10 (33%) patients. Steroids and intravenous immunoglobulins (IVIG) were administered to 24 (80%) and 12 (41%) patients respectively while 7 (23%) received both. Overall, 20% children expired. During the last five years, 30 and 47 children were diagnosed with KD and VM, respectively. Their comparison with MIS-C group showed lymphopenia, thrombocytosis, and higher CRP as well as more frequent atypical presentation in MIS-C KD group with less coronary involvement. The MIS-C VM was more likely to present with fulminant myocarditis. Conclusions: Our MIS-C cohort is younger with higher mortality compared to previous reports. MIS-C is distinct from historic cohorts of KD and VM in both in clinical features and outcomes.
    Keyword
    multisystem inflammatory syndrome (MIS-C)
    Children
    COVID-19
    Pakistan
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16074
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0253625
    Scopus Count
    Collections
    UMB Coronavirus Publications
    UMB Open Access Articles

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