• Shubhi Kaushik, Scott I Aydin, Kim R Derespina, Prerna B Bansal, Shanna Kowalsky, Rebecca Trachtman, Jennifer K Gillen, Michelle M Perez, Sara H Soshnick, Edward E Conway, Asher Bercow, Howard S Seiden, Robert H Pass, Henry M Ushay, George Ofori-Amanfo, and Shivanand S Medar.
• Department of Pediatrics, Division of Pediatric Critical Care Medicine, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY.
• J. Pediatr. 2020 Sep 1; 224: 24-29.

ObjectiveTo assess clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2-associated multisystem inflammatory syndrome in children (MIS-C).Study DesignChildren with MIS-C admitted to pediatric intensive care units in New York City between April 23 and May 23, 2020, were included. Demographic and clinical data were collected.ResultsOf 33 children with MIS-C, the median age was 10 years; 61% were male; 45% were Hispanic/Latino; and 39% were black. Comorbidities were present in 45%. Fever (93%) and vomiting (69%) were the most common presenting symptoms. Depressed left ventricular ejection fraction was found in 63% of patients with median ejection fraction of 46.6% (IQR, 39.5-52.8). C-reactive protein, procalcitonin, d-dimer, and pro-B-type natriuretic peptide levels were elevated in all patients. For treatment, intravenous immunoglobulin was used in 18 (54%), corticosteroids in 17 (51%), tocilizumab in 12 (36%), remdesivir in 7 (21%), vasopressors in 17 (51%), mechanical ventilation in 5 (15%), extracorporeal membrane oxygenation in 1 (3%), and intra-aortic balloon pump in 1 (3%). The left ventricular ejection fraction normalized in 95% of those with a depressed ejection fraction. All patients were discharged home with median duration of pediatric intensive care unit stay of 4.7 days (IQR, 4-8 days) and a hospital stay of 7.8 days (IQR, 6.0-10.1 days). One patient (3%) died after withdrawal of care secondary to stroke while on extracorporeal membrane oxygenation.ConclusionsCritically ill children with coronavirus disease-2019-associated MIS-C have a spectrum of severity broader than described previously but still require careful supportive intensive care. Rapid, complete clinical and myocardial recovery was almost universal.Copyright © 2020 Elsevier Inc. All rights reserved.

37 keywords...

hide…