1 - Unidade Infecciologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- 39th Annual Meeting of the European Society for Paediatric Infectious Diseases; E-Poster
Background Multisystem inflammatory syndrome in children (MIS-C), is a rare and severe manifestation of coronavirus disease 2019 (COVID-19). We aim to describe the characteristics of children admitted to a tertiary pediatric hospital in Portugal.
Case Presentation Summary We report 14 cases of MIS-C, between March 2020 to January 2021. The median age was 9,5 years old (IQR 4,75 – 12,25 years), 10 patients were male, eight were previously healthy and four had African ancestry. Six had positive SARS-CoV-2 rRT-PCR, nine positive serology and 11 known epidemiological context. All patients presented fever and organ system involvement including cardiovascular (14), gastrointestinal (14), mucocutaneous (14), hematologic (13), respiratory (9), renal (3) and neurologic (2). One patient had distributive and cardiogenic shock and four a distributive shock. Coronary-artery aneurysms (z scores ≥2.5) were documented in two patients (14%), and Kawasaki’s disease–like features were documented in four children (29%). The median maximum values of inflammation biomarkers were PCR 254,95mg/L (IQR 199,93 - 370,50), IL-6 220,25pg/mL (IQR 82,88 - 469,75), ferritin 650,35ng/mL (333,95 - 1266,10) and the median maximum values of cardiac biomarkers were troponin 214,00ng/mL (IQR 37,33 - 813,65), NT-pro-BNP 5331,00pg/mL (IQR 2496,75 - 12762,25). Intravenous immunoglobulin and methylprednisolone were used in all patients. Five patients needed intensive care, one mechanical ventilation and five vasoactive support. The complications included macrophage activation syndrome (1), cytomegalovirus reactivation (1), hypertension induced by glucocorticoid (2) and weight loss greater than 10% (4). There were no fatalities. Three months after discharge, two children showed myocardial fibrosis in cardiac magnetic resonance.
Learning Points/Discussion MIS-C has the potential to lead to serious life-threatening illness and sequelae in previously healthy children and adolescents.
Palavras Chave: children, COVID-19, multisystem inflammatory syndrome, SARS-CoV-2