• Marieke H Otten, BuysseCorinne M PCMPErasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatric Surgery, Rotterdam, The Netherlands., Emmeline P Buddingh, Terheggen-LagroSuzanne W JSWJDepartment of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Erik G J von Asmuth, Eleonore S V de Sonnaville, Naomi Ketharanathan, Heleen E Bunker-Wiersma, Lotte Haverman, Karin Hogenbirk, Matthijs de Hoog, Martien Humblet, JoostenKoen F MKFMErasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Pediatric Surgery, Rotterdam, The Netherlands., KneyberMartin C JMCJDivision of Paediatric Intensive Care, Department of Paediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands., Geanne Krabben, Joris Lemson, Nienke M Maas, Sofie Maebe, Peter P Roeleveld, Monique van Schooneveld, Brigitte Timmers-Raaijmaakers, Dick van Waardenburg, Jennifer C Walker, Renske Wassenberg, van WoenselJob B MJBMAmsterdam UMC, University of Amsterdam, Emma Children's Hospital, Department of Pediatric Intensive Care, Amsterdam Reproduction and Development, Amsterdam, The Netherlands., Esther de Wit, Diana W Wolthuis, Annelies van Zwol, Kim J Oostrom, Hennie Knoester, and Karolijn Dulfer.
• Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Department of Pediatric Intensive Care, Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
• Pediatr Crit Care Me. 2023 Apr 1; 24 (4): 289300289-300.

ObjectivesTo investigate neurocognitive, psychosocial, and quality of life (QoL) outcomes in children with Multisystem Inflammatory Syndrome in Children (MIS-C) seen 3-6 months after PICU admission.DesignNational prospective cohort study March 2020 to November 2021.SettingSeven PICUs in the Netherlands.PatientsChildren with MIS-C (0-17 yr) admitted to a PICU.InterventionsNone.Measurements And Main ResultsChildren and/or parents were seen median (interquartile range [IQR] 4 mo [3-5 mo]) after PICU admission. Testing included assessment of neurocognitive, psychosocial, and QoL outcomes with reference to Dutch pre-COVID-19 general population norms. Effect sizes (Hedges' g ) were used to indicate the strengths and clinical relevance of differences: 0.2 small, 0.5 medium, and 0.8 and above large. Of 69 children with MIS-C, 49 (median age 11.6 yr [IQR 9.3-15.6 yr]) attended follow-up. General intelligence and verbal memory scores were normal compared with population norms. Twenty-nine of the 49 followed-up (59%) underwent extensive testing with worse function in domains such as visual memory, g = 1.0 (95% CI, 0.6-1.4), sustained attention, g = 2.0 (95% CI 1.4-2.4), and planning, g = 0.5 (95% CI, 0.1-0.9). The children also had more emotional and behavioral problems, g = 0.4 (95% CI 0.1-0.7), and had lower QoL scores in domains such as physical functioning g = 1.3 (95% CI 0.9-1.6), school functioning g = 1.1 (95% CI 0.7-1.4), and increased fatigue g = 0.5 (95% CI 0.1-0.9) compared with population norms. Elevated risk for posttraumatic stress disorder (PTSD) was seen in 10 of 30 children (33%) with MIS-C. Last, in the 32 parents, no elevated risk for PTSD was found.ConclusionsChildren with MIS-C requiring PICU admission had normal overall intelligence 4 months after PICU discharge. Nevertheless, these children reported more emotional and behavioral problems, more PTSD, and worse QoL compared with general population norms. In a subset undergoing more extensive testing, we also identified irregularities in neurocognitive functions. Whether these impairments are caused by the viral or inflammatory response, the PICU admission, or COVID-19 restrictions remains to be investigated.Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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