1. 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
- Author
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Omaima Anis Bhatti, Ali Faisal Saleem, Nadeem Aslam, Qalab Abbas, Zuviya Ghazala Ali Khan, Farah Khalid, Adnan Bhutta, Devyani Chowdhary, Shazia Mohsin, Maha Inam, and Abdul Sattar Sheikh
- Subjects
RNA viruses ,Male ,Viral Diseases ,Viral Myocarditis ,Coronaviruses ,Epidemiology ,Fulminant ,030204 cardiovascular system & hematology ,Medical Conditions ,0302 clinical medicine ,Interquartile range ,Medicine and Health Sciences ,Medicine ,Pakistan ,030212 general & internal medicine ,Kawasaki Disease ,Child ,Pathology and laboratory medicine ,Virus Testing ,Multidisciplinary ,Organic Compounds ,Medical microbiology ,Clinical Laboratory Sciences ,Systemic Inflammatory Response Syndrome ,Myocarditis ,Clinical Laboratories ,Chemistry ,Infectious Diseases ,Phenotype ,Treatment Outcome ,Child, Preschool ,Physical Sciences ,Viruses ,Cohort ,Steroids ,Female ,SARS CoV 2 ,Pathogens ,Research Article ,medicine.medical_specialty ,SARS coronavirus ,Adolescent ,Science ,Immunology ,Cardiology ,Mucocutaneous Lymph Node Syndrome ,Microbiology ,Autoimmune Diseases ,03 medical and health sciences ,Diagnostic Medicine ,Internal medicine ,Humans ,Pandemics ,Biology and life sciences ,Thrombocytosis ,business.industry ,Organic Chemistry ,Chemical Compounds ,Organisms ,Viral pathogens ,Infant, Newborn ,COVID-19 ,Infant ,Toxic shock syndrome ,Covid 19 ,medicine.disease ,Microbial pathogens ,Clinical Immunology ,Kawasaki disease ,Clinical Medicine ,business - 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.
- Published
- 2021
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