Table 1 Demographic and clinical features of MIS-C patients across the COVID-19 waves
From: Distinct phenotypes of multisystem inflammatory syndrome in children: a cohort study
Demographic characteristics | |||||
|---|---|---|---|---|---|
All waves (n = 57) | Wave 1 (n = 7) | Wave 2 (n = 25) | Wave 3 (n = 17) | Wave 4 (n = 8) | |
Male sex (n, %) | 41 (72) | 5 (71) | 18 (72) | 14 (82) | 5 (63) |
Age at admission, years (median, IQR) | 6 (4–8) | 7 (1–8) | 5 (3–8) | 7 (4–9) | 7 (5–10) |
Clinical characteristics | |||||
All waves (n = 57) | Wave 1 (n = 7) | Wave 2 (n = 25) | Wave 3 (n = 17) | Wave 4 (n = 8) | |
History | |||||
Prematurity (n, %) | 1 (2) | 0 | 0 | 0 | 1 (13) |
Chronic comorbidity (n, %) | 5 (9) | 2 (29) | 1 (4) | 2 (12) | 0 |
Clinical signs and symptoms | |||||
Fulfillment of AHA Kawasaki disease’s criteria (n, %) | 22 (39) | 3 (43) | 13 (52) | 5 (29) | 1 (13) |
Days of fever at admission (median, IQR) | 5 (3–6) | 5 (4–15) | 5 (3–6) | 4 (4–5) | 4 (3–5) |
Total days of fever (median, IQR) | 5 (4–7) | 5 (5–15) | 6 (5–7) | 5 (4–6) | 5 (4–7) |
Extremity changes (n, %) | 42 (74) | 5 (71) | 20 (80) | 13 (76) | 4 (50) |
Skin rash (n, %) | 48 (84) | 7 (100) | 24 (96) | 13 (76) | 4 (50) |
Bilateral conjunctivitis without exudate (n, %) | 53 (93) | 6 (86) | 25 (100) | 15 (88) | 7 (88) |
Changes lips and/or oral cavity (n, %) | 41 (72) | 5 (71) | 21 (84) | 12 (71) | 3 (38) |
Cervical lymphadenopathy (> 1.5 cm) (n, %) | 9 (16) | 1 (14) | 5 (20) | 1 (6) | 2 (25) |
Gastrointestinal manifestations (n, %) | 55 (97) | 7 (100) | 25 (100) | 15 (88) | 8 (100) |
Shock/hypotension (n, %) | 50 (88) | 4 (57) | 24 (96) | 15 (88) | 7 (88) |
Laboratory features during hospitalization | |||||
Microbiological or serological evidence for SARS-CoV-2 exposure (n, %)1 | 47 (82) | 1 (14) | 22 (88) | 17 (100) | 7 (88) |
Coagulation dysfunction (INR > 1.1) (n, %) | 47 (82) | 7 (100) | 18 (72) | 14 (82) | 8 (100) |
INR value (median, IQR) | 1.4 (1.3–1.5) | 1.4 (1.2–1.5) | 1.4 (1.3–1.5) | 1.4 (1.3–1.7) | 1.3 (1.2–1.8) |
Peak C-reactive protein, mg/l (median, IQR) | 188.3 (105.0-234.3) | 200.0 (96.0-234.0) | 142.0 (89.0-187.5) | 201.0 (127.7-244.7) | 151.8 (72.0-302.3) |
Peak ferritin, µg/l (median, IQR) | 482 (315–1164) | 376 (247–512) | 417 (242–746) | 516 (451–1853) | 1426 (627–2048) |
Peak D-dimer, mg/l (median, IQR) | 3.42 (2.04–4.81) | 2.20 (1.08–3.27) | 2.26 (1.28–4.22) | 4.15 (2.23–5.36) | 5.41 (2.73–6.07) |
Peak troponin, ng/l (median, IQR) | 32.0 (15.0–72.0) | 7.0 (6.0-13.8) | 38.0 (19.0–69.0) | 40.0 (16.0–73.0) | 52.0 (20.8–79.5) |
Peak NT-proBNP, ng/l (median, IQR) | 7010 (1961–14,852) | 1217 (973–4810) | 4022 (1684–9790) | 12,983 (4901–30,302) | 12,901 (927-25493) |
Liver enzyme abnormalities (n, %) | 28 (49) | 3 (43) | 8 (32) | 11 (65) | 6 (75) |
Hyponatremia < 133 mmol/l (n, %) | 36 (63) | 2 (29) | 17 (68) | 11 (65) | 6 (75) |
Sodium nadir, mmol/l (median, IQR) | 132 (129–134) | 133 (130–136) | 132 (129–134) | 132 (128–134) | 131 (129–134) |
Hypoalbuminemia < 30 g/l (n, %) | 49 (86) | 6 (86) | 19 (76) | 16 (94) | 8 (100) |
Albumin nadir, g/l (median, IQR) | 20 (18–25) | 21 (18–24) | 24 (20–29) | 19 (16–20) | 23 (18–25) |
Thrombocytopenia < 150 × 10E9/l (n, %) | 29 (50.9) | 1 (14) | 10 (40) | 11 (65) | 7 (88) |
Platelet count nadir, x10E9/l (median, IQR) | 147 (115–230) | 262 (172–364) | 176 (124–315) | 140 (120–174) | 106 (58–148) |
Additional investigations | |||||
Concurrent other viral infection (n, %) | 4 (7) | 0 | 2 (8) | 1 (6) | 1 (13) |
Concurrent bacterial infection (with microbiological evidence) (n, %) | 2 (4) | 0 | 1 (4) | 1 (6) | 0 |
Coronary ectasia, dilatation and/or aneurysm on cardiac US (n, %) | 8 (14) | 3 (43) | 3 (12) | 2 (12) | 0 |
Ventricular dysfunction on cardiac US (n, %) | 20 (35) | 0 | 9 (36) | 7 (41) | 4 (50) |
Chest X-ray abnormalities (n, %) | 21 (37) | 3 (43) | 8 (32) | 6 (35) | 4 (50) |
Management | |||||
IVIG (n, %) | 57 (100) | 7 (100) | 25 (100) | 17 (100) | 8 (100) |
Corticosteroids (n, %) | 44 (77) | 3 (43) | 18 (72) | 15 (88) | 8 (100) |
Intravenous methylprednisolone pulses (in those treated with corticosteroids) (n, %) | 40 (91) | 3 (100) | 16 (89) | 15 (100) | 6 (75) |
Acetylsalicylic acid (n, %) | 57 (100) | 7 (100) | 25 (100) | 17 (100) | 8 (100) |
Hydroxychloroquine (n, %) | 0 | 0 | 0 | 0 | 0 |
Biologic agents (other than IVIG) (n, %) | 8 (14) | 2 (29) | 0 | 4 (24) | 2 (25) |
Antibiotics (n, %) | 52 (91) | 7 (100) | 24 (96) | 16 (94) | 5 (63) |
Antiviral treatment (n, %) | 1 (2) | 0 | 0 | 1 (6) | 0 |
Intensive care unit admission (n, %) | 30 (53) | 2 (29) | 15 (60) | 8 (47) | 5 (63) |
Vasopressors (n, %) | 30 (53) | 2 (29) | 15 (60) | 8 (47) | 5 (63) |
Non-invasive ventilation (CPAP, BiPAP) (n, %) | 2 (4) | 0 | 0 | 1 (6) | 1 (13) |
Mechanical ventilation (n, %) | 3 (5) | 0 | 0 | 3 (18) | 0 |