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Article ; Online: COVID-19 multisystem inflammatory syndrome in three teenagers with confirmed SARS-CoV-2 infection.

Ng, Khuen Foong / Kothari, Trishul / Bandi, Srini / Bird, Paul William / Goyal, Kanika / Zoha, Mohammad / Rai, Vinayak / Tang, Julian Wei-Tze

Journal of medical virology

2020 Volume 92, Issue 11, Page(s) 2880–2886

Abstract: ... disease entity coined as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 ... confirmed SARS-CoV-2 infection admitted to a pediatric intensive care unit for PIMS-TS ... of children. Here we describe the clinical presentations and outcomes of three teenagers with serologically ...

Abstract	Coronavirus disease 2019 (COVID-19) is generally a relatively mild illness in children. An emerging disease entity coined as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) has been reported recently, but is very rare and only affects a very small minority of children. Here we describe the clinical presentations and outcomes of three teenagers with serologically-confirmed SARS-CoV-2 infection admitted to a pediatric intensive care unit for PIMS-TS. Although their initial presentations were very similar, their COVID-19-related disease varied in severity.
MeSH term(s)	Adolescent ; COVID-19/diagnosis ; COVID-19/physiopathology ; COVID-19/therapy ; COVID-19 Serological Testing ; Female ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/diagnosis ; Systemic Inflammatory Response Syndrome/physiopathology ; Systemic Inflammatory Response Syndrome/therapy ; United Kingdom
Keywords	covid19
Language	English
Publishing date	2020-07-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.26206
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Article: COVID-19 multisystem inflammatory syndrome in three teenagers with confirmed SARS-CoV-2 infection

Ng, Khuen Foong / Kothari, Trishul / Bandi, Srini / Bird, Paul William / Goyal, Kanika / Zoha, Mohammad / Rai, Vinayak / Tang, Julian Wei-Tze

J. med. virol

Abstract	Coronavirus disease 2019 (COVID-19) is generally a relatively mild illness in children. An emerging disease entity coined as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) has been reported recently, but is very rare and only affects a very small minority of children. Here we describe the clinical presentations and outcomes of three teenagers with serologically-confirmed SARS-CoV-2 infection admitted to a pediatric intensive care unit for PIMS-TS. Although their initial presentations were very similar, their COVID-19-related disease varied in severity.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #610402
Database	COVID19

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Article ; Online: COVID‐19 multisystem inflammatory syndrome in three teenagers with confirmed SARS‐CoV‐2 infection

Ng, Khuen Foong / Kothari, Trishul / Bandi, Srini / Bird, Paul William / Goyal, Kanika / Zoha, Mohammad / Rai, Vinayak / Tang, Julian Wei‐Tze

Journal of Medical Virology

2020 Volume 92, Issue 11, Page(s) 2880–2886

Keywords	Virology ; Infectious Diseases ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	752392-0
ISSN	1096-9071 ; 0146-6615
ISSN (online)	1096-9071
ISSN	0146-6615
DOI	10.1002/jmv.26206
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Risk for severe outcomes of COVID-19 and PIMS-TS in children with SARS-CoV-2 infection in Germany.

Sorg, Anna-Lisa / Hufnagel, Markus / Doenhardt, Maren / Diffloth, Natalie / Schroten, Horst / von Kries, Rüdiger / Berner, Reinhard / Armann, Jakob

European journal of pediatrics

2022 Volume 181, Issue 10, Page(s) 3635–3643

Abstract: ... with either SARS-CoV-2 or pediatric inflammatory multisystem syndrome (PIMS-TS, also known as MIS-C) - in order ... study (the SARS-CoV-2 KIDS study), the nationwide, state-based reporting system for PCR-confirmed SARS ... Although children and adolescents have a lower burden of SARS-CoV-2-associated disease compared ...

Abstract	Although children and adolescents have a lower burden of SARS-CoV-2-associated disease compared to adults, assessing the risk for severe outcomes among SARS-CoV-2-infected children remains difficult due to a high rate of undetected cases. We combine data from three data sources - a national seroprevalence study (the SARS-CoV-2 KIDS study), the nationwide, state-based reporting system for PCR-confirmed SARS-CoV-2 infections in Germany, and a nationwide registry on children and adolescents hospitalized with either SARS-CoV-2 or pediatric inflammatory multisystem syndrome (PIMS-TS, also known as MIS-C) - in order to provide estimates on the risk of hospitalization for COVID-19-related treatment, intensive care admission, and death due to COVID-19 and PIMS-TS in children. The rate of hospitalization for COVID-19-related treatment among all SARS-CoV-2 seropositive children was 7.13 per 10,000, ICU admission 2.21 per 10,000, and case fatality was 0.09 per 10,000. In children without comorbidities, the corresponding rates for severe or fatal disease courses were substantially lower. The lowest risk for the need of COVID-19-specific treatment was observed in children aged 5-11 without comorbidities. In this group, the ICU admission rate was 0.37 per 10,000, and case fatality could not be calculated due to the absence of cases. The overall PIMS-TS rate was 2.47 per 10,000 SARS-CoV-2 infections, the majority being children without comorbidities. Conclusion: Overall, the SARS-CoV-2-associated burden of a severe disease course or death in children and adolescents is low. This seems particularly the case for 5-11-year-old children without comorbidities. By contrast, PIMS-TS plays a major role in the overall disease burden among all pediatric age groups. What is known: • SARS-CoV-2-associated burden of disease in children is considered to be low, but accurate risk estimates accounting for clinically undiagnosed infections are lacking. • Asymptomatic SARS-CoV-2 infections are common in children. What is new: • We provide risk estimates for hospitalization for COVID-19-related treatment, ICU admission, death from COVID-19, and PIMS-TS for children with SARS-CoV-2 infections by pooling different data sources. • The risk for PIMS-TS exceeds the risk for severe COVID-19 in all age groups; the risk for severe COVID-19 is the lowest in 5-11 years old.
MeSH term(s)	Adolescent ; Adult ; COVID-19/complications ; COVID-19/epidemiology ; COVID-19/therapy ; Child ; Child, Preschool ; Germany/epidemiology ; Humans ; SARS-CoV-2 ; Seroepidemiologic Studies ; Systemic Inflammatory Response Syndrome
Language	English
Publishing date	2022-08-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-022-04587-5
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Article ; Online: Children with SARS-CoV-2 infection during the novel coronaviral disease (COVID-19) outbreak in Iran: an alarming concern for severity and mortality of the disease.

Mamishi, Setareh / Pourakbari, Babak / Mehdizadeh, Mehrzad / Navaeian, Amene / Eshaghi, Hamid / Yaghmaei, Bahareh / Hosseinpour Sadeghi, Reihaneh / Poormohammadi, Shiva / Mahmoudieh, Yasmine / Mahmoudi, Shima

BMC infectious diseases

2022 Volume 22, Issue 1, Page(s) 382

Abstract: ... disease, multisystem inflammatory syndrome in children (MIS-C) and children with acute COVID-19, as well ... years) with suspected COVID-19 who had positive results for SARS-CoV-2.: Results: Among the 262 ... Background: The rapid worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS ...

Abstract	Background: The rapid worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections led to public health crises globally and the number of pediatric patients with Coronavirus Disease 2019 (COVID-19) is still rising. The aim of this study was to describe the epidemiological, clinical, laboratory, and imaging features of hospitalized patients with COVID-19 at an Iranian referral pediatrics hospital and to compare these parameters between hospitalized patients with and without severe disease, multisystem inflammatory syndrome in children (MIS-C) and children with acute COVID-19, as well as deceased and discharged cases. Methods: This study included hospitalized children and adolescents (≤ 18 years) with suspected COVID-19 who had positive results for SARS-CoV-2. Results: Among the 262 patients with suspected COVID-19, 142 confirmed COVID-19 cases were included in the study. A total of 11 children were diagnosed as MIS-C. The majority of the cases with MIS-C were male, (n = 9, 82%) which is significantly higher than children (n = 61, 47%) with acute COVID-19 (P = 0.03). Fifty patients (35%) were shown to have a more severe form of COVID-19. Ninety percent of the cases (n = 45) with severe COVID-19 had comorbidities that was significantly higher than cases with non-severe or mild disease (n = 41, 45%; P < 0.0001). A mortality rate of 10% was reported (n = 14). Ninety-three percent of the deceased cases (n = 13) had comorbidities that were significantly higher than discharged patients (n = 73, 57%; P = 0.009). Conclusion: The increasing number of children with severe COVID-19 is cause for great concern. Underlying diseases, mainly cardiovascular diseases, cancer, and malignancies, are associated with greater risk of development of severe COVID-19 and even death in children. On the other hand, pediatric patients with MIS-C usually develop a milder form of the disease. However, evaluation specific immunological responses in children to explore the delayed inflammatory syndrome are highly recommended.
MeSH term(s)	Adolescent ; COVID-19/complications ; Child ; Disease Outbreaks ; Female ; Humans ; Iran/epidemiology ; Male ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome/epidemiology
Language	English
Publishing date	2022-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-022-07200-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: COVID-19 In Children Across Three Asian Cosmopolitan Regions

Chua, Gilbert T / Xiong, Xiaoli / Choi, Eun Hwa / Han, Mi Seon / Chang, Sung Hee / Jin, Byoung Lo / Lee, Eun Joo / Kim, Baek Nam / Kim, Min Kyoung / Doo, Kihyun / Seo, Ju Hee / Kim, Yae Jean / Kim, Yeo Jin / Park, Ji Young / Suh, Sun Bok / Lee, Hyunju / Cho, Eun Young / Kim, Dong Hyun / Kim, Jong Min /

Kim, Hye Young / Park, Su Eun / Lee, Joon Kee / Jo, Dae Sun / Cho, Seung Man / Choi, Jae Hong / Jo, Kyo Jin / Choe, Young June / Kim, Ki Hwan / Chi, Shuiqing / Tang, Shao-Tao / Qin, Huan / Zhou, Li Shan / Chen, Peng / Wong, Joshua Sung Chih / Chan, Kate Ching Ching / Yau, Felix Yat Sun / Lam, Shu Yan / Chow, Calvin Chit Kwong / Wong, Tak Wai / Chan, Victor / Poon, Grace Wing Kit / Chow, Chun Bong / Wong, Wilfred Hs / Lau, Yu Lung / Chan, Godfrey Chi Fung / Chui, Celine Sl / Li, Xue / Ho, Marco Hok Kung / Wong, Ian Ck / Tam, Paul Kwong Hang

Emerg Microbes Infect

Abstract: ... inflammatory syndrome temporally associated with SARS-CoV-2 (PMIS-TS). In general, adolescents were more likely ... Asian cohort summarizing the clinical observations is warranted. Children confirmed with COVID-19 ... As another wave of COVID-19 outbreak has approached in July 2020, a larger scale COVID-19 pediatric ...

Abstract	As another wave of COVID-19 outbreak has approached in July 2020, a larger scale COVID-19 pediatric Asian cohort summarizing the clinical observations is warranted. Children confirmed with COVID-19 infection from the Republic of Korea, the Hong Kong Special Administrative Region (HKSAR) and Wuhan, China, during their first waves of local outbreaks were included. Their clinical characteristics and the temporal sequences of the first waves of local paediatric outbreaks were compared. 423 children with COVID-19 were analyzed. Wuhan had the earliest peak, followed by Korea and HKSAR. Compared with Korea and Wuhan, patients in HKSAR were significantly older (mean age: 12.9 vs. 10.8 vs. 6.6 years, p<0.001, respectively) and had more imported cases (87.5% vs. 16.5% vs. 0%, p<0.001, respectively). The imported cases were also older (13.4 vs. 7.6 years, p<0.001). More cases in HKSAR were asymptomatic compared to Korea and Wuhan (45.5% vs. 22.0% vs. 20.9%, p<0.001, respectively), and significantly more patients from Wuhan developed fever (40.6% vs. 29.7% vs. 21.6%, p=0.003, respectively). There were significantly less imported cases than domestic cases developing fever after adjusting for age and region of origin (p=0.046). 5.4% to 10.8% of patients reported anosmia and ageusia. None developed pediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PMIS-TS). In general, adolescents were more likely to be asymptomatic and less likely to develop fever, but required longer hospital stays. In conclusion, majority patients in this pediatric Asian cohort had a mild disease. None developed PIMS-TS. Their clinical characteristics were influenced by travel history and age.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #900320
Database	COVID19

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Article ; Online: Clinical characteristics of children and young people hospitalised with covid-19 in the United Kingdom: prospective multicentre observational cohort study

Swann, Olivia V / Holden, Karl A / Turtle, Lance / Pollock, Louisa / Fairfield, Cameron J / Drake, Thomas M / Seth, Sohan / Egan, Conor / Hardwick, Hayley / Halpin, Sophie / Girvan, Michelle / Donohue, Chloe / Pritchard, Mark G / Patel, Latifa / Ladhani, Shamez / Sigfrid, Louise / Sinha, Ian P / Olliaro, Piero L / Nguyen-Van-Tam, Jonathan S /

Horby, Peter W / Merson, Laura / Carson, Gail / Dunning, W Jake / Openshaw, Peter JM / Baillie, J Kenneth / Harrison, Ewen M / Docherty, Annemarie B / Semple, Malcolm Gracie / ISARIC Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators

medRxiv

Abstract: ... to hospital with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, and ... inflammatory syndrome in children and adolescents temporarily related to covid-19 (MIS-C). Design Prospective ... confirmed SARS-CoV-2. Main Outcome Measures Admission to critical care (high dependency or intensive care ...

Abstract	Objective To characterise the clinical features of children and young people admitted to hospital with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, and explore factors associated with admission to critical care, mortality, and development of multisystem inflammatory syndrome in children and adolescents temporarily related to covid-19 (MIS-C). Design Prospective observational cohort study with rapid data gathering and near real time analysis. Setting 260 acute care hospitals in England, Wales, and Scotland between 17th January and 5th June 2020, with a minimal follow-up time of two weeks (to 19th June 2020). Participants 451 children and young people aged less than 19 years admitted to 116 hospitals and enrolled into the International Severe Acute Respiratory and emergency Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK study with laboratory-confirmed SARS-CoV-2. Main Outcome Measures Admission to critical care (high dependency or intensive care), in-hospital mortality, or meeting the WHO preliminary case definition for MIS-C. Results Median age was 3.9 years [interquartile range (IQR) 0.3-12.9 years], 36% (162/451) were under 12 months old, and 57% (256/450) were male. 56% (224/401) were White, 12% (49/401) South Asian and 10% (40/401) Black. 43% (195/451) had at least one recorded comorbidity. A muco-enteric cluster of symptoms was identified, closely mirroring the WHO MIS-C criteria. 17% of children (72/431) were admitted to critical care. On multivariable analysis this was associated with age under one month odds ratio 5.05 (95% confidence interval 1.69 to 15.72, p=0.004), age 10 to 14 years OR 3.11 (1.21 to 8.55, p=0.022) and Black ethnicity OR 3.02 (1.30 to 6.84, p=0.008). Three young people died (0.7 %, 3/451) aged 16 to 19 years, all of whom had profound comorbidity. Twelve percent of children (36/303) met the WHO MIS-C criteria, with the first patient developing symptoms in mid-March. Those meeting MIS-C criteria were older, (median age 10.8 years ([IQR 8.4-14.1] vs 2.0 [0.2-12.6]), p<0.001) and more likely to be of non-White ethnicity (70% (23/33) vs 43% (101/237), p=0.005). Children with MIS-C were four times more likely to be admitted to critical care (61% (22/36) vs 15% (40/267, p<0.001). In addition to the WHO criteria, children with MIS-C were more likely to present with headache (45% (13/29) vs 11% (19/171), p<0.001), myalgia (39% (11/28) vs 7% (12/170), p<0.001), sore throat (37% (10/27) vs (13% (24/183, p = 0.004) and fatigue (57% (17/30) vs 31% (60/192), p =0.012) than children who did not and to have a platelet count of less than 150 x109/L (30% (10/33) vs 10% (24/232), p=0.004). Conclusions Our data confirms less severe covid-19 in children and young people than in adults and we provide additional evidence for refining the MIS-C case definition. The identification of a muco-enteric symptom cluster also raises the suggestion that MIS-C is the severe end of a spectrum of disease. Study registration ISRCTN66726260
Keywords	covid19
Language	English
Publishing date	2020-07-17
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.07.14.20153320
Database	COVID19

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Article ; Online: Clinical characteristics of children and young people hospitalised with covid-19 in the United Kingdom: prospective multicentre observational cohort study

Horby, Peter W / Merson, Laura / Carson, Gail / Dunning, W Jake / Openshaw, Peter JM / Baillie, J Kenneth / Harrison, Ewen M / Docherty, Annemarie B / Semple, Malcolm Gracie / Investigators, - ISARIC Coronavirus Clinical Characterisation Consortium

Abstract	Objective To characterise the clinical features of children and young people admitted to hospital with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the UK, and explore factors associated with admission to critical care, mortality, and development of multisystem inflammatory syndrome in children and adolescents temporarily related to covid-19 (MIS-C). Design Prospective observational cohort study with rapid data gathering and near real time analysis. Setting 260 acute care hospitals in England, Wales, and Scotland between 17th January and 5th June 2020, with a minimal follow-up time of two weeks (to 19th June 2020). Participants 451 children and young people aged less than 19 years admitted to 116 hospitals and enrolled into the International Severe Acute Respiratory and emergency Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK study with laboratory-confirmed SARS-CoV-2. Main Outcome Measures Admission to critical care (high dependency or intensive care), in-hospital mortality, or meeting the WHO preliminary case definition for MIS-C. Results Median age was 3.9 years [interquartile range (IQR) 0.3-12.9 years], 36% (162/451) were under 12 months old, and 57% (256/450) were male. 56% (224/401) were White, 12% (49/401) South Asian and 10% (40/401) Black. 43% (195/451) had at least one recorded comorbidity. A muco-enteric cluster of symptoms was identified, closely mirroring the WHO MIS-C criteria. 17% of children (72/431) were admitted to critical care. On multivariable analysis this was associated with age under one month odds ratio 5.05 (95% confidence interval 1.69 to 15.72, p=0.004), age 10 to 14 years OR 3.11 (1.21 to 8.55, p=0.022) and Black ethnicity OR 3.02 (1.30 to 6.84, p=0.008). Three young people died (0.7 %, 3/451) aged 16 to 19 years, all of whom had profound comorbidity. Twelve percent of children (36/303) met the WHO MIS-C criteria, with the first patient developing symptoms in mid-March. Those meeting MIS-C criteria were older, (median age 10.8 years ([IQR 8.4-14.1] vs 2.0 [0.2-12.6]), p<0.001) and more likely to be of non-White ethnicity (70% (23/33) vs 43% (101/237), p=0.005). Children with MIS-C were four times more likely to be admitted to critical care (61% (22/36) vs 15% (40/267, p<0.001). In addition to the WHO criteria, children with MIS-C were more likely to present with headache (45% (13/29) vs 11% (19/171), p<0.001), myalgia (39% (11/28) vs 7% (12/170), p<0.001), sore throat (37% (10/27) vs (13% (24/183, p = 0.004) and fatigue (57% (17/30) vs 31% (60/192), p =0.012) than children who did not and to have a platelet count of less than 150 x109/L (30% (10/33) vs 10% (24/232), p=0.004). Conclusions Our data confirms less severe covid-19 in children and young people than in adults and we provide additional evidence for refining the MIS-C case definition. The identification of a muco-enteric symptom cluster also raises the suggestion that MIS-C is the severe end of a spectrum of disease. Study registration ISRCTN66726260
Keywords	covid19
Publisher	MedRxiv; WHO
Document type	Article ; Online
Note	WHO #Covidence: #20153320
DOI	10.1101/2020.07.14.20153320
Database	COVID19

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Article ; Online: Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain.

García-Salido, Alberto / de Carlos Vicente, Juan Carlos / Belda Hofheinz, Sylvia / Balcells Ramírez, Joan / Slöcker Barrio, María / Leóz Gordillo, Inés / Hernández Yuste, Alexandra / Guitart Pardellans, Carmina / Cuervas-Mons Tejedor, Maite / Huidobro Labarga, Beatriz / Vázquez Martínez, José Luís / Gutiérrez Jimeno, Míriam / Oulego-Erróz, Ignacio / Trastoy Quintela, Javier / Medina Monzón, Carmen / Medina Ramos, Laura / Holanda Peña, María Soledad / Gil-Antón, Javier / Sorribes Ortí, Clara /

Flores González, José Carlos / Hernández Palomo, Rosa María / Sánchez Ganfornina, Inma / Fernández Romero, Emilia / García-Besteiro, María / López-Herce Cid, Jesús / González Cortés, Rafael

Critical care (London, England)

2020 Volume 24, Issue 1, Page(s) 666

Abstract: ... with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia.: Methods ... Background: Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been ... with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation ...

Abstract	Background: Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods: A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results: Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5-11.8) vs 3.4 years (IQR 0.4-9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5-8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions: MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients.
MeSH term(s)	Adolescent ; COVID-19/epidemiology ; Child ; Child, Preschool ; Female ; Humans ; Intensive Care Units, Pediatric ; Male ; Pandemics ; Pneumonia, Viral/epidemiology ; Prospective Studies ; Registries ; SARS-CoV-2 ; Spain/epidemiology ; Systemic Inflammatory Response Syndrome/epidemiology
Language	English
Publishing date	2020-11-26
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-020-03332-4
Database	MEDical Literature Analysis and Retrieval System OnLINE

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