1 - Unidade de Infecciologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- 8th Congress of the European Academy of Paediatric Societies; E-Poster
Resumo:
Background and aims Severe COVID-19 is rare in children. However, there are critically ill patients with multisystem inflammatory syndrome in children (MIS-C). We aim to characterize pediatric patients with MIS-C admitted to a Portuguese tertiary hospital.
Methods Observational, retrospective study of pediatric patients admitted with MIS-C from March 1 to August 15, 2020. Collected information included demographic data, clinical evolution, laboratory results and administrated drugs. The diagnosis of MIS-C was based on criteria by WHO and CDC.
Results Out of 274 SARS-CoV-2 infections, 108 children were hospitalized. Four hospitalized children met MIS-C criteria: median age 5.5 years (4-13 years), 3/4 male, 2/4 with African ancestry, 3/4 previously healthy, 3/4 with unfavourable socio-economic conditions. All patients had fever, myocarditis and organ system involvement including cardiovascular (4), coagulopathy (4), gastrointestinal (4), dermatologic (4), respiratory (2), renal (1) and neurologic (1). Two patients needed intensive care and one received ionotropic support and mechanical ventilation. All patients had elevated inflammation markers and three had lymphopenia. SARS-CoV-2 by RT-PCR was positive in 3/4 and 3/4 had SARS-CoV-2 antibodies. All patients received intravenous immunoglobulin and corticosteroids and two received remdesivir. All patients had significant weight loss and one had macrophage activation syndrome. The median duration of hospitalization was 18 days. Clinical and laboratory improvement was observed in all cases.
Conclusions MIS-C is a severe clinical presentation of COVID-19 in children. We observed a large spectrum of disease presentation. Although multiorgan dysfunction is transversal in MIS-C, myocarditis is an important complication that should have long term follow-up.
Palavras Chave: children, COVID-19, MIS-C