MADRID, 12 Apr. (EUROPE PRESS) –
A new study has found that older children and those with elevated blood markers of inflammation (ferritin) are at greatest risk of severe multisystem inflammatory syndrome in children (MIS-C) and admission to the intensive care unit ( ICU), according to the researchers published in ‘CMAJ’ (Canadian Medical Association Journal).
The international study involved 232 children under the age of 18 admitted to one of 15 centers — 13 in Canada, 1 in Costa Rica, and 1 in Iran — for suspected SMI-C between March 1, 2020, and March 7, 2020. March 2021.
The patients met the World Health Organization definition for SMI-C, which includes persistent fever for at least 3 days; elevated C-reactive protein, indicating inflammation; disease involving 2 or more systems with no obvious microbial cause of inflammation; and positivity for COVID-19 or suspected contact with a positive case.
The majority of patients (89%) had gastrointestinal symptoms, such as pain, and dermatological problems, such as rashes and swelling (85%). Cardiac involvement was common (59%), as were blood coagulation abnormalities (90%). Of the 232 children, 73 (31.5%) were admitted to the ICU, and 47 (64%) of them required treatment for very low blood pressure.
The risk of admission to the ICU was greater in children aged 6 to 12 years (44%) and 13 to 17 years (46%) than in those aged 0 to 5 years (18%). Furthermore, children admitted to hospital later in the pandemic (between November 2020 and March 2021) were more likely to be admitted to the ICU (50 of 112, 45%) than those hospitalized earlier (23 of 120, 19 %).
The authors point out the difficulties in diagnosing SMI-C. “Multisystem inflammatory syndrome in children is a new diagnosis, with different diagnostic criteria that have not been validated,” writes Dr. Joan Robinson, a pediatrician at the University of Alberta, Canada.
“Most of these children had no history of contact with a person with proven SARS-CoV-2 infection,” he adds. “Identifying exposure can be difficult, as infected contacts may be asymptomatic or have never undergone to the tests.”
The authors call for international consensus on SARS-CoV diagnostic criteria to improve clinical care and research.
–
