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MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) DURING SARS-COV-2 PANDEMIC IN BRAZIL: A MULTICENTER, PROSPECTIVE COHORT STUDY
Síndrome inflamatória multissistema em crianças
MIS-C
Coronavírus
COVID-19
Crianças
Multisystem inflammatory syndrome in children
MIS-C
Coronavirus
COVID-19
Children
https://www.arca.fiocruz.br/handle/icict/44605
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Abstract
Objective: To describe the clinical, laboratory, and radiological characteristics, as well as theoutcomes of children with MIS-C. Method: Multicenter, prospective cohort study, conducted in 17 pediatric intensive care units in five states in Brazil, from March to July 2020. Patients from 1 month to 19 years who met the MIS-C diagnostic criteria were included consecutively. Results: Fifty-six patients were included, with the following conditions: Kawasaki-like disease(n = 26), incomplete Kawasaki disease (n = 16), acute cardiac dysfunction (n = 10), toxic shock syndrome (n = 3), and macrophage activation syndrome (n = 1). Median age was 6.2 years (IQR2.4−10.3), 70% were boys, 59% were non-whites, 20% had comorbidities, 48% reported a contact with COVID-19 cases, and 55% had a recent SARS-CoV-2 infection confirmed by RT-PCR and/or serology. Gastrointestinal symptoms were present in 71%, shock symptoms in 59%, and severe respiratory symptoms in less than 20%. d-Dimer was increased in 80% and cardiac dysfunction markers in more than 75%. Treatment included immunoglobulin (89%); corticosteroids, antibi-otics, and enoxaparin in about 50%; and oseltamivir and antifungal therapy in less than 10%. Only 11% needed invasive mechanical ventilation, with a median duration of five days (IQR 5---6.5). The median length of PICU stay was six days (IQR 5---11), and one death occurred (1.8%). Conclusions: Most characteristics of the present MIS-C patients were similar to that of other cohorts. The present results may contribute to a broader understanding of SARS-CoV-2 infection in children and its short-term consequences. Long-term multidisciplinary follow-up is needed, since it is not known whether these patients will have chronic cardiac impairment or other sequelae.
Keywords in Portuguese
SARS-CoV-2Síndrome inflamatória multissistema em crianças
MIS-C
Coronavírus
COVID-19
Crianças
Keywords
SARS-CoV-2Multisystem inflammatory syndrome in children
MIS-C
Coronavirus
COVID-19
Children
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