Publication:

Multisystem inflammatory syndrome in children in Coastal Andhra, India

Background Multisystem inflammatory syndrome in children (MIS-C) associated with COVID is a recently emerged disease and there is limited Indian data. We reported the presentation and clinical course of these children.

Methods All children who had symptoms and signs of MIS-C according to WHO criteria and those positive for SARS-CoV-2, were considered for the study. Clinical features, lab parameters, treatment details and outcome were documented.

Results 104 children, who had MIS-C during the study period. Out of them, 52 (50%) required respiratory support. Among those who required respiratory support 13 (12%) children required invasive ventilation, 11 (10.5%) children could be managed with noninvasive ventilation, whereas 28 (27%) children required supplemental oxygen. 18 (17%) children had signs of myocarditis and left ventricular dysfunction.  12 (11.5%) children had pulmonary edema and Coronary artery dilatation was present in 4(4%) cases. Steroids were used as main stay of therapy. Low dose intravenous methylprednisolone was administered to72(69%); pulse dose methylprednisolone was administered to 12 (12%) children. Intravenous immunoglobulins (IVIG) administered to 20 (19%) children. Among the study group, 103 children survived and one child expired (0.96%).

Conclusions Optimal use of immunomodulators and frequent hemodynamic assessment with functional ECHO to optimize the inotropes, can improve the outcomes among those with myocardial dysfunction.