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Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic.
Int J Infect Dis. 2020 Nov; 100:75-81.IJ

Abstract

OBJECTIVE

To describe the clinical and epidemiological characteristics of hospitalized children with multisystem inflammatory syndrome in children (MIS-C) in Santiago, Chile.

METHODS

This was an observational study of children with MIS-C (May 1 to June 24, 2020), in three pediatric hospitals in Santiago. Demographic characteristics and epidemiological data, medical history, laboratory tests, cardiology evaluations, treatment, and clinical outcomes were analyzed.

RESULTS

Twenty-seven patients were admitted (median age 6, range 0-14 years). Sixteen of the 27 (59%) required intensive care unit admission; there were no deaths. Seventy-four percent had no comorbidities, and the median number of days of symptoms before admission was 4 (range 2-9 days). Gastrointestinal symptoms were the most frequent, and inflammatory markers were increased at admission. A recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was detected in 82% of cases. The severe group showed significantly lower hemoglobin and albumin levels, decreased platelet counts, and higher d-dimer during disease evolution. Echocardiography showed abnormalities (myocardial, pericardial, or coronary) in 12 patients (46%) during their hospital stay. Anti-inflammatory treatment (immunoglobulin and/or corticosteroids) was prescribed in 24 patients. MIS-C appeared in clusters weeks after the peak of SARS-CoV-2 cases, especially in the most vulnerable areas of Santiago.

CONCLUSIONS

This study describes the first series (n = 27) of children with MIS-C in a Latin American country, showing favorable clinical outcomes. Education and alerts are required for clinical teams to establish an early diagnosis and prompt treatment.

Authors+Show Affiliations

Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Antonio Varas 360, Providencia, Santiago, Chile.Department of Pediatrics, Hospital Exequiel González Cortés, Faculty of Medicine, Universidad de Chile, José Miguel Carrera 3100, Piso 3, San Miguel, Santiago, Chile.Department of Pediatrics, Hospital Roberto del Río, Faculty of Medicine, Universidad de Chile, Profesor Zañartu 1085, Independencia, Santiago, Chile.Department of Pediatrics, Hospital San Juan de Dios, Faculty of Medicine, Universidad de Chile, Huérfanos 3255, Santiago, Chile.Department of Pediatrics, Hospital Dr. Sótero del Río, Av. Concha y Toro 3459, Puente Alto, Santiago, Chile; Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.Pediatrics Department, Hospital Luis Calvo Mackenna, Antonio Varas 360, Providencia, Santiago, Chile.Pediatric Intensive Care Unit, Hospital Exequiel Gonzalez Cortés, José Miguel Carrera 3300, San Miguel, Santiago, Chile.Pediatric Infectious Disease Unit, Hospital Exequiel Gonzalez Cortés, José Miguel Carrera 3300, San Miguel, Santiago, Chile.Department of Pediatrics, Hospital Roberto del Río, Faculty of Medicine, Universidad de Chile, Profesor Zañartu 1085, Independencia, Santiago, Chile.Department of Pediatrics, Hospital Roberto del Río, Faculty of Medicine, Universidad de Chile, Profesor Zañartu 1085, Independencia, Santiago, Chile; Virology Program, ICBM, Faculty of Medicine, Universidad de Chile, Independencia 1027 Pabellón J, Independencia, Santiago, Chile. Electronic address: ltapia@med.uchile.cl.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

32861823

Citation

Torres, Juan P., et al. "Multisystem Inflammatory Syndrome in Children (MIS-C): Report of the Clinical and Epidemiological Characteristics of Cases in Santiago De Chile During the SARS-CoV-2 Pandemic." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 100, 2020, pp. 75-81.
Torres JP, Izquierdo G, Acuña M, et al. Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic. Int J Infect Dis. 2020;100:75-81.
Torres, J. P., Izquierdo, G., Acuña, M., Pavez, D., Reyes, F., Fritis, A., González, R., Rivacoba, C., Contardo, V., & Tapia, L. I. (2020). Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 100, 75-81. https://doi.org/10.1016/j.ijid.2020.08.062
Torres JP, et al. Multisystem Inflammatory Syndrome in Children (MIS-C): Report of the Clinical and Epidemiological Characteristics of Cases in Santiago De Chile During the SARS-CoV-2 Pandemic. Int J Infect Dis. 2020;100:75-81. PubMed PMID: 32861823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic. AU - Torres,Juan P, AU - Izquierdo,Giannina, AU - Acuña,Mirta, AU - Pavez,Daniela, AU - Reyes,Felipe, AU - Fritis,Ana, AU - González,Ricardo, AU - Rivacoba,Carolina, AU - Contardo,Verónica, AU - Tapia,Lorena I, Y1 - 2020/08/28/ PY - 2020/07/18/received PY - 2020/08/17/revised PY - 2020/08/22/accepted PY - 2020/8/31/pubmed PY - 2020/12/2/medline PY - 2020/8/31/entrez KW - COVID-19 KW - MIS-C multisystem inflammatory syndrome in children KW - SARS-CoV-2 SP - 75 EP - 81 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int J Infect Dis VL - 100 N2 - OBJECTIVE: To describe the clinical and epidemiological characteristics of hospitalized children with multisystem inflammatory syndrome in children (MIS-C) in Santiago, Chile. METHODS: This was an observational study of children with MIS-C (May 1 to June 24, 2020), in three pediatric hospitals in Santiago. Demographic characteristics and epidemiological data, medical history, laboratory tests, cardiology evaluations, treatment, and clinical outcomes were analyzed. RESULTS: Twenty-seven patients were admitted (median age 6, range 0-14 years). Sixteen of the 27 (59%) required intensive care unit admission; there were no deaths. Seventy-four percent had no comorbidities, and the median number of days of symptoms before admission was 4 (range 2-9 days). Gastrointestinal symptoms were the most frequent, and inflammatory markers were increased at admission. A recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was detected in 82% of cases. The severe group showed significantly lower hemoglobin and albumin levels, decreased platelet counts, and higher d-dimer during disease evolution. Echocardiography showed abnormalities (myocardial, pericardial, or coronary) in 12 patients (46%) during their hospital stay. Anti-inflammatory treatment (immunoglobulin and/or corticosteroids) was prescribed in 24 patients. MIS-C appeared in clusters weeks after the peak of SARS-CoV-2 cases, especially in the most vulnerable areas of Santiago. CONCLUSIONS: This study describes the first series (n = 27) of children with MIS-C in a Latin American country, showing favorable clinical outcomes. Education and alerts are required for clinical teams to establish an early diagnosis and prompt treatment. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/32861823/Multisystem_inflammatory_syndrome_in_children__MIS_C_:_Report_of_the_clinical_and_epidemiological_characteristics_of_cases_in_Santiago_de_Chile_during_the_SARS_CoV_2_pandemic_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1201-9712(20)30691-3 DB - PRIME DP - Unbound Medicine ER -