RT journal article
T1 Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain
A1 García‑Salido, Alberto
A1 de Carlos Vicente, Juan Carlos
A1 Hofheinz, Sylvia Belda
A1 Balcells Ramírez, Joan
A1 Slöcker Barrio, María
A1 Leóz Gordillo, Inés
A1 Hernández Yuste, Alexandra
A1 Guitart Pardellans, Carmina
A1 Cuervas‑Mons Tejedor, Maite
A1 Huidobro Labarga, Beatriz
A1 Vázquez Martínez, José Luis
A1 Gutiérrez Jimeno, Miriam
A1 Oulego‑Erróz, Ignacio
A1 Trastoy Quintela, Javier
A1 Medina Monzón, Carmen
A1 Medina Ramos, Laura
A1 Holanda Peña, María Soledad
A1 Gil‑Antón, Javier
A1 Sorribes Ortí, Clara
A1 Flores González, José Carlos
A1 Hernández Palomo, Rosa María
A1 Sánchez Ganfornina, Inma
A1 Fernández Romero, Emilia
A1 García‑Besteiro, María
A1 López‑Herce Cid, Jesús
A1 González Cortés, Rafael
A1 Spanish Pediatric Intensive Care Society working group on SARS‑CoV‑2 infection
A2 Materno-Infantil y Radiología
K1 SARS-CoV-2
K1 Pediatric multisystem inflammatory syndrome temporally associated with COVID-19
K1 Kawasaki disease
K1 Toxic shock syndrome
K1 Children
K1 Critical care
K1 Shock
AB Background Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5-11.8) vs 3.4 years (IQR 0.4-9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5-8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients.
PB BMC
SN 1364-8535
YR 2020
FD 2020-12
LK http://hdl.handle.net/10498/24269
UL http://hdl.handle.net/10498/24269
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 11-nov-2026