Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic

Int J Infect Dis. 2020 Nov:100:75-81. doi: 10.1016/j.ijid.2020.08.062. Epub 2020 Aug 28.

Abstract

Objective: To describe the clinical and epidemiological characteristics of hospitalized children with multisystem inflammatory syndrome in children (MIS-C) in Santiago, Chile.

Methods: This was an observational study of children with MIS-C (May 1 to June 24, 2020), in three pediatric hospitals in Santiago. Demographic characteristics and epidemiological data, medical history, laboratory tests, cardiology evaluations, treatment, and clinical outcomes were analyzed.

Results: Twenty-seven patients were admitted (median age 6, range 0-14 years). Sixteen of the 27 (59%) required intensive care unit admission; there were no deaths. Seventy-four percent had no comorbidities, and the median number of days of symptoms before admission was 4 (range 2-9 days). Gastrointestinal symptoms were the most frequent, and inflammatory markers were increased at admission. A recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was detected in 82% of cases. The severe group showed significantly lower hemoglobin and albumin levels, decreased platelet counts, and higher d-dimer during disease evolution. Echocardiography showed abnormalities (myocardial, pericardial, or coronary) in 12 patients (46%) during their hospital stay. Anti-inflammatory treatment (immunoglobulin and/or corticosteroids) was prescribed in 24 patients. MIS-C appeared in clusters weeks after the peak of SARS-CoV-2 cases, especially in the most vulnerable areas of Santiago.

Conclusions: This study describes the first series (n = 27) of children with MIS-C in a Latin American country, showing favorable clinical outcomes. Education and alerts are required for clinical teams to establish an early diagnosis and prompt treatment.

Keywords: COVID-19; MIS-C multisystem inflammatory syndrome in children; SARS-CoV-2.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Betacoronavirus*
  • COVID-19
  • Child
  • Child, Preschool
  • Chile / epidemiology
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome / epidemiology*
  • Systemic Inflammatory Response Syndrome / therapy

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related