All hands on deck: A multidisciplinary approach to SARS-CoV-2-associated MIS-C.
COVID-19
Critical illness
MIS-C
Sepsis
Surveillance
Journal
Paediatrics & child health
ISSN: 1205-7088
Titre abrégé: Paediatr Child Health
Pays: England
ID NLM: 9815960
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
26
07
2021
accepted:
24
01
2022
entrez:
27
5
2022
pubmed:
28
5
2022
medline:
28
5
2022
Statut:
epublish
Résumé
Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of SARS-CoV-2 infection with overlapping features of Kawasaki disease and toxic shock syndrome. In May 2020, a provincial multidisciplinary working group was established in anticipation of emerging cases following the first wave of SARS-CoV-2 infections. Our centre established a multidisciplinary working group for MIS-C cases in British Columbia. The group developed guidelines using the World Health Organization MIS-C case definition. Guidelines were updated using quality improvement methods as new reports and our local experience evolved. We included all children who were evaluated in person or had samples sent to our centre for MIS-C evaluation from May 2020 to April 2021. We prospectively collected patient demographics, clinical and laboratory characteristics, and treatment. Fifty-two children were included. Eleven were diagnosed as confirmed MIS-C. Ten of the 11 MIS-C cases presented with shock. Gastrointestinal and mucocutaneous involvement were also prominent. Common laboratory features included elevated C-reactive protein, D-dimer, troponin, and brain natriuretic peptide. Four out of 11 (36%) had myocardial dysfunction and 3/11 (27%) had coronary artery abnormalities. All 11 patients had evidence of SARS-CoV-2 infection. Ten out of 11 (91%) received intravenous (IV) immunoglobulin and IV corticosteroids. Our provincial cohort of MIS-C patients were more likely to present with shock and cardiac dysfunction, require ICU admission, and be treated with corticosteroids compared to ruled out cases. Our working group's evolving process ensured children with features of MIS-C were rapidly identified, had standardized evaluation, and received appropriate treatment in our province.
Sections du résumé
Background
UNASSIGNED
Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious complication of SARS-CoV-2 infection with overlapping features of Kawasaki disease and toxic shock syndrome. In May 2020, a provincial multidisciplinary working group was established in anticipation of emerging cases following the first wave of SARS-CoV-2 infections.
Methodology
UNASSIGNED
Our centre established a multidisciplinary working group for MIS-C cases in British Columbia. The group developed guidelines using the World Health Organization MIS-C case definition. Guidelines were updated using quality improvement methods as new reports and our local experience evolved. We included all children who were evaluated in person or had samples sent to our centre for MIS-C evaluation from May 2020 to April 2021. We prospectively collected patient demographics, clinical and laboratory characteristics, and treatment.
Results
UNASSIGNED
Fifty-two children were included. Eleven were diagnosed as confirmed MIS-C. Ten of the 11 MIS-C cases presented with shock. Gastrointestinal and mucocutaneous involvement were also prominent. Common laboratory features included elevated C-reactive protein, D-dimer, troponin, and brain natriuretic peptide. Four out of 11 (36%) had myocardial dysfunction and 3/11 (27%) had coronary artery abnormalities. All 11 patients had evidence of SARS-CoV-2 infection. Ten out of 11 (91%) received intravenous (IV) immunoglobulin and IV corticosteroids.
Conclusion
UNASSIGNED
Our provincial cohort of MIS-C patients were more likely to present with shock and cardiac dysfunction, require ICU admission, and be treated with corticosteroids compared to ruled out cases. Our working group's evolving process ensured children with features of MIS-C were rapidly identified, had standardized evaluation, and received appropriate treatment in our province.
Identifiants
pubmed: 35620558
doi: 10.1093/pch/pxab110
pii: pxab110
pmc: PMC9126281
doi:
Types de publication
Journal Article
Langues
eng
Pagination
S53-S58Investigateurs
May A Ahmed
(MA)
Vilte Barakauskas
(V)
Eleni Galanis
(E)
David Goldfarb
(D)
Jessica Halparin
(J)
Kevin C Harris
(KC)
Niranjan Kissoon
(N)
Sally Lawrence
(S)
Dominique McGuffin
(D)
Garth Meckler
(G)
Kirsten Noel
(K)
Dewi Schrader
(D)
Michelle Sherwood
(M)
Avash Singh
(A)
Suzanne Vercauteren
(S)
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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