Abstract
Aim: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection may result in a life-threatening hyperinflammatory condition named multisystem inflammatory syndrome in children (MIS-C). We aimed to assess demographics, clinical presentations, laboratory characteristics and treatment outcomes of patients with MIS-C.
Methods: We performed a retrospective study of patients with MIS-C managed between August 2020 and March 2021 at Dr. Sami Ulus Maternity Child Health and Diseases Training and Research Hospital in Turkey.
Results: A total of 45 patients (23 male, 51%) with a median age of 8.7 years (interquartile range: 5.6-11.7 years) were enrolled to study. The SARS-CoV-2 serology was positive in 43 (95%) patients. Organ-system involvement included the dermatologic in 41 (91%), cardiovascular in 39 (87%), hematologic in 36 (80%) and gastrointestinal in 36 (80%) patients. Acute anterior uveitis was diagnosed in nine (20%) patients. Two patients presented with clinical findings of deep neck infection such as fever, neck pain, trismus, swelling and induration on the cervical lymph node. One patient presented with Henoch-Schonlein purpura-like eruption. Coronary artery dilatation was detected in five (11%) patients. For treatment of MIS-C, intravenous immunoglobulin was used in 44 (98%) patients, methylprednisolone in 27 (60%) and anakinra in 9 (20%) patients. The median duration of hospitalisation was nine days. All patients recovered.
Conclusions: Children with MIS-C might have variable clinical presentations. Acute anterior uveitis might be a prominent presentation of MIS-C and require ophthalmological examination. It is essential to make patient-based decisions and apply a stepwise approach for the treatment of this life-threatening disease.
Keywords: SARS-CoV-2; acute anterior uveitis; children; multisystem inflammatory syndrome associated with COVID-19.
【저자키워드】 SARS-CoV-2, children, acute anterior uveitis, multisystem inflammatory syndrome associated with COVID-19., 【초록키워드】 Methylprednisolone, Treatment, Intravenous immunoglobulin, Treatment outcome, Anakinra, serology, Infection, severe acute respiratory syndrome coronavirus-2, Turkey, severe acute respiratory syndrome Coronavirus, MIS-C, cardiovascular, Severe acute respiratory syndrome, Retrospective study, Clinical findings, Immunoglobulin, Child, Fever, male, Patient, Gastrointestinal, laboratory characteristics, hospitalisation, disease, child health, patients, Coronavirus-2, Inflammatory, Lymph node, demographics, Henoch-Schönlein Purpura, Coronary artery, training, Clinical finding, maternity, Uveitis, Anterior uveitis, interquartile range, acute respiratory syndrome, Clinical presentations, acute respiratory syndrome coronavirus, median age, one patient, two patients, syndrome, life-threatening, swelling, hematologic, positive, eruption, Hyperinflammatory, Neck pain, duration of hospitalisation, approach, FIVE, deep neck infection, induration, trismus, enrolled, performed, was used, diagnosed, nine, median, Two patient, interquartile, with COVID-19, 【제목키워드】 pandemic, Coronavirus-2, Inflammatory, acute respiratory syndrome, syndrome,