Clinical and Laboratory Parameters Associated with PICU Admission in Children with Multisystem Inflammatory Syndrome Associated with COVID-19 (MIS-C).

Publication date: Sep 23, 2024

Background/Objectives: Multisystem Inflammatory Syndrome in children (MIS-C) is a rare but severe post-infectious complication of COVID-19 that often requires admission to the Pediatric Intensive Care Unit (PICU). The present study aimed to compare the demographic, clinical, and laboratory characteristics of children diagnosed with MIS-C who were admitted to the PICU and those who did not require PICU admission. Methods: Children diagnosed with MIS-C from September 2020 to April 2023 were included in this case-control study. Demographic, clinical, and laboratory data were collected from medical records. Results: Fifty children with MIS-C were included in the study [median (IQR) age: 7. 5 (4. 3, 11. 4) years, 28/50 (56%) males]. Twenty-two (22/50, 44%) children required admission to the PICU. In the multivariate regression analysis, hepatic (OR: 12. 89, 95%CI: 1. 35-123. 41, p-value = 0. 03) and cardiological involvement (OR: 34. 55, 95%CI: 2. 2-541. 91, p-value = 0. 01) were significantly associated with hospitalization at the PICU. Regarding the laboratory and imaging parameters during the first 48 h from admission, D-dimer levels higher than 4 μg/mL and decreased Left Ventricular Ejection Fraction (LVEF) were associated with an increased risk of PICU admission (OR: 7. 95, 95%CI: 1. 48-42. 78, p-value = 0. 02 and OR = 1. 28, 95%CI: 1. 07-1. 53, p-value = 0. 01). Children who were admitted to the PICU were more likely to develop complications during their hospitalization (10/22, 45. 5% vs. 3/28, 10. 7%, p-value = 0. 005) and were hospitalized for more days than children in the pediatric ward (median length of stay (IQR): 20 (15, 28) days vs. 8. 5 (6, 14) days, p-value < 0. 001). Conclusions: The findings of this study indicate that cardiovascular and hepatic involvement and increased D-dimer levels in children with MIS-C might be associated with admission to the PICU.

Open Access PDF

Concepts	Keywords
April	critical care
Cardiological	D-dimer
Males	LVEF
Pediatric	MIS-C
	PICU
	SARS-CoV-2

Semantics

Type	Source	Name
disease	MESH	Syndrome
disease	MESH	COVID-19
disease	MESH	Multisystem Inflammatory Syndrome in children
disease	MESH	complications
disease	MESH	Infectious Diseases
drug	DRUGBANK	Coenzyme M
disease	IDO	entity
disease	MESH	infection
disease	MESH	inflammation
disease	MESH	shock
disease	MESH	critically ill
disease	IDO	facility
disease	IDO	country
drug	DRUGBANK	Methionine
disease	MESH	hypotension
disease	MESH	tachycardia
disease	MESH	oliguria
disease	MESH	anuria
disease	MESH	Respiratory Failure
disease	MESH	hypoxemia
disease	MESH	hypercapnia
disease	MESH	Cardiac Failure
disease	MESH	pulmonary edema
disease	MESH	Sepsis
disease	MESH	Myocarditis
disease	MESH	Pericarditis
disease	MESH	Abnormalities
disease	IDO	symptom
drug	DRUGBANK	Immune Globulin Human
disease	MESH	pulmonary embolism
disease	MESH	Hemophagocytic Lymphohistiocytosis
disease	IDO	blood
drug	DRUGBANK	Fibrinogen Human
drug	DRUGBANK	Nesiritide
drug	DRUGBANK	Prothrombin
disease	MESH	Thrombosis
drug	DRUGBANK	Iron
drug	DRUGBANK	Oxygen
drug	DRUGBANK	Anakinra
disease	MESH	pleural effusion
disease	MESH	bleeding
disease	MESH	acute renal failure
disease	MESH	pericardial effusion
disease	MESH	thrombocytopenia
disease	MESH	lymphopenia
disease	MESH	hyponatremia
drug	DRUGBANK	Human Serum Albumin
disease	MESH	appendicitis

Original Article

(Visited 1 times, 1 visits today)