Abstract
BackgroundMultisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide. Here we report the first case series of 7 children diagnosed with MIS-C in Qatar.MethodsClinical features and outcomes of COVID-19 positive patients admitted to Sidra Medicine, Qatar from June to October 2020, who met the WHO case definition for MIS-C were reviewed.ResultsThe mean age in our case series was 5.6 years, of which 71.4% were males. All patients were previously healthy but had a history of COVID-19 infection. Fever, rash, vomiting and abdominal pain were the most common symptoms (70–100%). The average hospitalization was 12.9 days with no case fatalities. Laboratory findings included lymphopenia and thrombocytopenia in most patients, as well as evidence of coagulopathy and elevated inflammatory markers such as C-reactive protein, ferritin and procalcitonin. Many patients (71.4%) required inotropic support in intensive care, while only one required respiratory support. Although all patients had elevated cardiac biomarkers, cardiovascular involvement was observed in 42.9% of patients with one patient developing a giant coronary aneurysm. All patients received intravenous immunoglobulin (IVIG) and 86% of patients received corticosteroids, with two patients requiring treatment with IL-1 inhibitors.ConclusionsOur report is one of the first reports on MIS-C from Asia. Although clinical features and outcomes are not significantly different from those reported elsewhere, lack of case fatalities in our cohort may indicate that early recognition and prompt medical attention is necessary for a favorable outcome in MIS-C.
Highlights
Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide
At the time of this report, there were approximately 138, 000 COVID-19 cases and 237 associated deaths reported in Qatar
A total of 167 children were positive for COVID-19 by RT-qPCR, and 7 of these patients fulfilled the World Health Organization (WHO) criteria for MIS-C and were managed in our hospital
Summary
Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide. We report the first case series of 7 children diagnosed with MIS-C in Qatar. The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a catastrophic effect on the human population with approximately 20% of infected persons experiencing severe or critical disease, and an overall case fatality rate of 2.3% [1]. Multisystem Inflammatory Syndrome in Children (MISC) is a rare but serious medical condition associated with COVID-19 [2]. The causes of MIS-C remain unknown but it has been associated with SARS-CoV-2 infection [3]. 40–50% of children with MIS-C meet criteria for complete or incomplete Kawasaki disease (KD). The true incidence of MIS-C is still uncertain but an estimated incidence of 0.6% among laboratory confirmed COVID-19 patients has been reported in New York [5]
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