Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study
Objective: To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes 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...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-05-01
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| Series: | Jornal de Pediatria |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755720302254 |
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| author | Fernanda Lima-Setta Maria Clara de Magalhães-Barbosa Gustavo Rodrigues-Santos Elaine Augusta das Neves Figueiredo Melissa de Lorena Jacques Raquel de Seixas Zeitel Roberto Sapolnik Cibelle Teixeira da Siva Borges Vanessa Soares Lanziotti Roberta Esteves Vieira de Castro Ana Paula Novaes Bellinat Thiago Peres da Silva Felipe Rezende Caino de Oliveira Bárbara Carvalho Santos dos Reis Natália Almeida de Arnaldo Silva Rodriguez Castro João Henrique Garcia Cobas Macedo Ana Carolina Cabral Pinheiro Scarlato Paula Marins Riveiro Isabele Coelho Fonseca da Mota Vivian Botelho Lorenzo Natalia Martins Lima de Lucena Zina Maria Almeida de Azevedo Antonio José L.A. Cunha Arnaldo Prata-Barbosa |
| author_facet | Fernanda Lima-Setta Maria Clara de Magalhães-Barbosa Gustavo Rodrigues-Santos Elaine Augusta das Neves Figueiredo Melissa de Lorena Jacques Raquel de Seixas Zeitel Roberto Sapolnik Cibelle Teixeira da Siva Borges Vanessa Soares Lanziotti Roberta Esteves Vieira de Castro Ana Paula Novaes Bellinat Thiago Peres da Silva Felipe Rezende Caino de Oliveira Bárbara Carvalho Santos dos Reis Natália Almeida de Arnaldo Silva Rodriguez Castro João Henrique Garcia Cobas Macedo Ana Carolina Cabral Pinheiro Scarlato Paula Marins Riveiro Isabele Coelho Fonseca da Mota Vivian Botelho Lorenzo Natalia Martins Lima de Lucena Zina Maria Almeida de Azevedo Antonio José L.A. Cunha Arnaldo Prata-Barbosa |
| author_sort | Fernanda Lima-Setta |
| collection | DOAJ |
| description | Objective: To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes 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 (IQR 2.4−10.3), 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, antibiotics, 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. |
| first_indexed | 2024-04-13T07:38:41Z |
| format | Article |
| id | doaj.art-03ff9c999bb64708b594267938cc7efe |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-13T07:38:41Z |
| publishDate | 2021-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-03ff9c999bb64708b594267938cc7efe2022-12-22T02:55:58ZengElsevierJornal de Pediatria0021-75572021-05-01973354361Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort studyFernanda Lima-Setta0Maria Clara de Magalhães-Barbosa1Gustavo Rodrigues-Santos2Elaine Augusta das Neves Figueiredo3Melissa de Lorena Jacques4Raquel de Seixas Zeitel5Roberto Sapolnik6Cibelle Teixeira da Siva Borges7Vanessa Soares Lanziotti8Roberta Esteves Vieira de Castro9Ana Paula Novaes Bellinat10Thiago Peres da Silva11Felipe Rezende Caino de Oliveira12Bárbara Carvalho Santos dos Reis13Natália Almeida de Arnaldo Silva Rodriguez Castro14João Henrique Garcia Cobas Macedo15Ana Carolina Cabral Pinheiro Scarlato16Paula Marins Riveiro17Isabele Coelho Fonseca da Mota18Vivian Botelho Lorenzo19Natalia Martins Lima de Lucena20Zina Maria Almeida de Azevedo21Antonio José L.A. Cunha22Arnaldo Prata-Barbosa23Instituto D’Or de Pesquisa e Ensino (IDOR), Departamento de Pediatria, Rio de Janeiro, RJ, Brazil; Instituto Fernandes Figueira, Unidade de Pacientes Graves, Fiocruz, Rio de Janeiro, RJ, BrazilInstituto D’Or de Pesquisa e Ensino (IDOR), Departamento de Pediatria, Rio de Janeiro, RJ, BrazilInstituto D’Or de Pesquisa e Ensino (IDOR), Departamento de Pediatria, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Pediátrico Unimed, Belém, PA, BrazilPediatric ICU, Hospital Quinta D’Or, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Pedro Ernesto, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital São Rafael, Salvador, BA, BrazilPediatric ICU, Hospital São Camilo Cura D’Ars, Fortaleza, CE, BrazilUniversidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Pedro Ernesto, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Martagão Gesteira, Salvador, BA, BrazilPediatric ICU, Hospital Real D’Or, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Alvorada Moema, São Paulo, SP, BrazilPediatric ICU, Complexo Hospitalar de Niterói, Niterói, RJ, BrazilHospital da Criança, Faculdade de Medicina, Departamento de Pediatria, São José do Rio Preto, SP, BrazilPediatric ICU, Hospital Copa D’Or, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Rios D’Or, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Caxias D’Or, Duque de Caxias, RJ, BrazilPediatric ICU, Hospital Jutta Batista, Rio de Janeiro, RJ, BrazilPediatric ICU, Hospital Couto Maia, Salvador, BA, BrazilPediatric ICU, Hospital Monte Klinikum, Fortaleza, CE, BrazilInstituto Fernandes Figueira, Unidade de Pacientes Graves, Fiocruz, Rio de Janeiro, RJ, BrazilInstituto D’Or de Pesquisa e Ensino (IDOR), Departamento de Pediatria, Rio de Janeiro, RJ, Brazil; Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BrazilInstituto D’Or de Pesquisa e Ensino (IDOR), Departamento de Pediatria, Rio de Janeiro, RJ, Brazil; Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Corresponding author.Objective: To describe the clinical, laboratory, and radiological characteristics, as well as the outcomes 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 (IQR 2.4−10.3), 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, antibiotics, 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.http://www.sciencedirect.com/science/article/pii/S0021755720302254SARS-CoV-2Multisystem inflammatory syndrome in childrenMIS-CCoronavirusCOVID-19Children |
| spellingShingle | Fernanda Lima-Setta Maria Clara de Magalhães-Barbosa Gustavo Rodrigues-Santos Elaine Augusta das Neves Figueiredo Melissa de Lorena Jacques Raquel de Seixas Zeitel Roberto Sapolnik Cibelle Teixeira da Siva Borges Vanessa Soares Lanziotti Roberta Esteves Vieira de Castro Ana Paula Novaes Bellinat Thiago Peres da Silva Felipe Rezende Caino de Oliveira Bárbara Carvalho Santos dos Reis Natália Almeida de Arnaldo Silva Rodriguez Castro João Henrique Garcia Cobas Macedo Ana Carolina Cabral Pinheiro Scarlato Paula Marins Riveiro Isabele Coelho Fonseca da Mota Vivian Botelho Lorenzo Natalia Martins Lima de Lucena Zina Maria Almeida de Azevedo Antonio José L.A. Cunha Arnaldo Prata-Barbosa Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study Jornal de Pediatria SARS-CoV-2 Multisystem inflammatory syndrome in children MIS-C Coronavirus COVID-19 Children |
| title | Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study |
| title_full | Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study |
| title_fullStr | Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study |
| title_full_unstemmed | Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study |
| title_short | Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 pandemic in Brazil: a multicenter, prospective cohort study |
| title_sort | multisystem inflammatory syndrome in children mis c during sars cov 2 pandemic in brazil a multicenter prospective cohort study |
| topic | SARS-CoV-2 Multisystem inflammatory syndrome in children MIS-C Coronavirus COVID-19 Children |
| url | http://www.sciencedirect.com/science/article/pii/S0021755720302254 |
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