Clinical Profile and Treatment of Multisystem Inflammatory Syndrome in Children (MIS-C) Linked to COVID-19 at Tertiary Care Centre in Western India

Abstract

Aims: To assess the clinical presentation and therapeutic interventions administered to patients suffering from MIS-C in a tertiary centre in Western India. Study Design:  This is a cross sectional observational study. Place and Duration of Study:  Department of Pediatrics at Rajiv Gandhi Medical College, Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra. It was conducted from September 2021-September 2022. Methodology: Patients were clinically diagnosed as MIS-C based on the the Centers for Disease Control and Prevention (CDC) guidelines and retrospective analysis was carried out by reviewing medical records and complementary investigations. Results: There were 36 children in total, 21 female (58.3%) and 15 males (41.7%) with ages ranging from less than 1 year to 18 years with mean age of 7.2 years. The symptoms were classified based on the organ system involved. Fever was present in most of the patients and Gastrointestinal symptoms in 18 (50%) were the most common followed by respiratory and Central Nervous System symptoms. Investigations revealed that White Blood Cell (WBC) count was predominantly normal in 77.8 %, with lymphocytopenia in 77.8% and reduced Hemoglobin (80.6 %). Inflammatory markers such as D-dimer, Erythrocyte sedimentation rate and serum Ferritin were raised in 94%, 88.9%, 86.1% respectively. Most of the patients 34 (94%), were treated with Intravenous steroids. IV immunoglobulin was given in 29 (80.6%). Out of the total 36 patients, there were 2 deaths. Conclusion: Although SARS-CoV-2 infection is less severe in children than in adults, some pediatric patients may present with severe symptoms requiring intensive care. This case series of patients with MIS-C post COVID-19 identified patterns of clinical presentation and organ system involvement. Most were treated and responded to steroids and immunoglobulins.