Clinical and Laboratory Patterns of Multisystem Inflammatory Syndrome in Children Related to Coronavirus Disease 2019 in the West of Iran

Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C) was first warned by the National Health Service in England following coronavirus disease 2019 (COVID-19) pandemic. Objectives: We aimed to evaluate the clinical and laboratory findings of MIS-C to be used for timely diagnosis and preventing possible complications. Methods: This descriptive study was conducted on 47 patients under 21 years old diagnosed with MIS-C. Results: We found that 25 (53.2%) patients were male, and the median age of participants was 5.58 years. The most common clinical manifestations were fever, rash, conjunctival injection, mucous membrane changes, periorbital edema, gastrointestinal symptoms, respiratory distress, tachycardia, and swollen hands and feet. C-reactive protein and erythrocyte sedimentation rate were elevated in 85 and 45.5% of cases at presentation, respectively. Chest X-ray (CXR) was performed for all cases, and a computed tomography (CT) scan was carried out for patients with severe pulmonary symptoms or abnormal CXR. The results of most CT scans were normal. Decreased myocardial function in echocardiography was detected in more than half of the cases. All patients received intravenous immunoglobulins, and more than 90% received steroids as co-administration therapy or second-line treatment. Conclusions: According to our findings, simultaneous fever, diarrhea, vomiting, and limb or periorbital edema is a key feature for MIS-C diagnosis. Moreover, the evidence of COVID-19 should be assessed in suspected cases of toxic shock syndrome or Kawasaki disease due to highly similar manifestations of these two diseases with MIS-C secondary to COVID-19.