Publication:

Clinical characteristics of multi-inflammatory syndrome in children associated with COVID 19 at the time of first contact with a primary care physician: an observational study

Background MIS-C is a new clinical syndrome with many similarities with well-known common childhood illness. This present study aims to describe the clinical profile at the time of first contact with the primary care provider and to delineate it from other common illness.

Methods Retrospective observational study in a referral hospital, GMC Thrissur, Kerala. All 43 diagnosed cases during the study period were enrolled. Data was retrieved from the case sheets and reference letters. Data was analysed in Statistical package for social sciences (SPSS) 20 software.

Results 43 patients were diagnosed with MIS-C with a mean age at diagnosis was 7.3 years with a male preponderance. Fever was the universal symptom, gastrointestinal symptoms in 27 (62.7%), rash in 24 (55.8%), shock in 2 (4.6%), lymphadenopathy in 2, seizures in 2, altered sensorium in 1, palatal palsy in 1etc were the presenting symptoms. 12 (27.9%) of patients had no history of COVID 19 infection. The mean latency for MIS-C was 21 days (range 6-60 days). 17 (39.5%) patients developed shock later.

Conclusions The symptom triad of fever, rash and gastrointestinal symptoms was the common presenting symptom at the first contact. Fever was present in all children. One third of patients had no history of symptomatic covid 19. Shock was the presenting symptom only in 2 (4.6%), but subsequently 17 (39.5%) children developed shock within 5 days of onset of symptoms. High index of suspicion and vigilance should be maintained by the primary care provider for the timely diagnosis and referral to higher centre.