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ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 6  |  Page : 270-277

A multicenter study of clinical and biochemical profiles, treatments, and short-term outcomes in children with multisystem inflammatory syndrome associated with SARS-CoV-2 infection from Western India


1 Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
2 SRCC Children's Hospital, Mumbai, Maharashtra, India
3 Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
4 KEM Hospital, Pune, Maharashtra, India
5 Sai Child Care Hospital, Navi Mumbai, Maharashtra, India
6 Department of Pediatrics, Bharati Vidyapeeth Medical College and Hospital, Mumbai, Maharashtra, India
7 Jupitor Hospital, Mumbai, Maharashtra, India
8 Apollo Hospital, Navi Mumbai, Maharashtra, India
9 Fortis Hospital, Mumbai, Maharashtra, India
10 Jehangir Apollo Hospital, Pune, Maharashtra, India
11 Sahyadri Superspeciality Hospital, Pune, Maharashtra, India
12 Shaishav Children's Hospital and Research Center, Pune, Maharashtra, India

Correspondence Address:
Dr. Rachit Mehta
Department of Pediatric Intensive Care, Kokilaben Dhirubhai Ambani Hospital. Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpcc.jpcc_60_21

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Background: Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) infection can lead to multisystem inflammatory syndrome in children (MIS-C). This study was conducted to study epidemiology, clinical profile, treatment strategies associated in children MIS-C in two cities in Western India. Subjects and Methods: This is a retrospective, observational study of children who fulfilled the criteria for MIS-C, admitted to eleven pediatric intensive care units (PICUs) in Western India during the first wave SARS-CoV-2 infection in India, between February 2020 and December 2020. Demographic and clinical data including laboratory parameters, treatment regimens, and outcomes were collected and analyzed. Results: Of the 234 children presenting with MIS-C, they were categorized into 3 clinical phenotypes: fever and hyperinflammation, Kawasaki disease (KD)-like, and shock with multisystem organ dysfunction syndrome (MODS). C-reactive protein, procalcitonin (PCT), D-dimer, and pro-B-type natriuretic peptide levels were elevated in all patients. Intravenous immunoglobulin (IVIG) was used in 128 (54.7%), corticosteroids in 214 (91.45%), tocilizumab in 1 (0.4%), and remdesivir in 4 (1.7%). 95 (40.5%) children required vasopressors and invasive mechanical ventilation was necessary in 26 (11.1%). Two hundred and twenty-nine patients were discharged home with median duration of PICU stay of 4 days and hospital stay of 7 days, and 5 (2.1%) patients died during treatment. Significant reduction in the duration of hospital stay was observed in those who received both steroid and IVIG (P < 0.05) and also in the shock ± MODS group (P < 0.05). Conclusions: Combination of steroid and IVIG for the treatment of MISC, especially with Shock and MODS reduce the duration of PICU stay than treated with steroid alone.


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