Nearly 70% of children hospitalized with multisystem syndrome were in good health

The observational and descriptive study took place between April 2020 and April 2021 and aimed to describe the characteristics of children hospitalized at D. Estefânia Pediatric Hospital, Lisbon, with Multisystem Inflammatory Syndrome (MIS-C).

For this, demographic and clinical data, diagnostic and therapeutic tests, complications and sequelae of the disease were analyzed.

Among other findings, the study concludes that, although no deaths were recorded among the 45 patients with MIS-C hospitalized in D.Estefânia, the overwhelming majority (90,4%) of the 21 patients evaluated six months after discharge showed a decrease in exercise tolerance and 53,3% persistent heart damage.

“In fact, we have observed several cardiac, physical and psychological sequelae and, for this reason, it is important to emphasize that these patients must have a long follow-up, with particular emphasis on cardiac involvement, since this is a characteristic of MIS-C,” the researchers point out.

Of the 312 patients hospitalized with SARS-Cov-2 infection, which causes covid-19, during this period at the pediatric hospital, 45 had MIS-C (14,4%), according to the study carried out by pediatricians Maria João Brito, Joana Vieira de Melo, Tiago Silva, Rita Valssasina and Catarina Gouveia.

SARS-CoV-2 infection was confirmed by diagnostic test (RT-PCR) or serology in 77,8% of patients and 73,3% had an epidemiological context linked to covid-19.

“As in previous reports, we found a similar mean age (seven years), a slight predominance of male patients (68,9%), and most patients were previously healthy (68,9%),” indicates the study published in the journal Ordem dos Médicos. .

The most common symptoms on admission to hospital were fever (100%), followed by abdominal pain (60%), vomiting (53,3%), rash (48,9%) and bilateral conjunctival hyperemia (28,9%).

The study authors report that a "broad spectrum" of disease presentation was seen in a group of mostly previously healthy patients.

All patients had fever and multivisceral involvement: hematological (100%), cardiovascular (97,8%), gastrointestinal (97,8%), mucocutaneous (86,7%), respiratory (26,7%) ), neurological (15,6%) and renal (13,3%). ).

“Neurological and respiratory impairment occurred in the most severe patients,” the study points out, indicating that 13 patients (28,8%) required intensive care.

However, he points out, even these patients had "a good short-term outcome", with no recorded deaths.

According to the study, the average time between the onset of symptoms and admission to hospital was six days, "a long period given the potential severity of the disease", they point out.

According to the researchers, these data lead to the conclusion that this syndrome is not always recognized, given the possibility of a more benign presentation, but, they specify, "in all cases, this syndrome has potentially serious consequences and must motivate careful monitoring and hospitalization”. ” .

“The diagnosis of MIS-C is a challenge in current clinical practice and requires a high level of suspicion because prompt initiation of treatment is essential to prevent complications,” they argue.

However, there is still no scientific consensus on the best therapy and follow-up for these patients.

“MIS-C is a serious disease associated with SARS-CoV-2 infection and evidence is still needed to clarify the different aspects of this syndrome,” they state.


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