Multisystem inflammatory syndrome associated with coronavirus disease in children a multi-centered study in Belem, Para, Brazil

Fundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, Brazil / Metropolitan University Center of the Amazon. Department of child health. Belém, PA, Brazil.Universidade Federal do Rio Grande do Sul. Department of Pediatrics. Division of Pediatric Intensive Care. Porto Alegre, RS, Brazil.Fundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, Brazil.Fundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, BrazilFundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, BrazilFundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, BrazilFundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, BrazilFundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, BrazilFundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, BrazilFundação Santa Casa de Misericórdia do Pará Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, BrazilFundação Hospital das Clínicas Gaspar Viana’s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, Brazil.Pró-Infantil’s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, Brazil.Pronto Socorro Municipal Mário Pinotti’s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, Brazil.Pronto Socorro Municipal Mário Pinotti’s Hospital. Department of Pediatrics. Division of Pediatric Intensive Care. Belém, PA, Brazil.Universidade Federal do Rio Grande do Sul. Department of Pediatrics. Division of Pediatric Intensive Care. Porto Alegre, RS, Brazil / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.We described the characteristics of 11 children with pediatric multisystem inflammatory syndrome-temporally associated with SARS-CoV-2. The main clinical indications for hospital admission were vasogenic toxic shock (n = 2), Kawasaki disease (n = 4), and Kawasaki disease shock syndrome (n = 5). The echocardiography findings were abnormal in 63% of cases. All patients had 2 or more organ dysfunctions, and the mortality rate was 18%

Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting

Abstract SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo–18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2–28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3–202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4–13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization