POS1262 A COHORT STUDY OF COVID-19 RELATED MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN AND ADOLESCENTS FROM MULTIPLE TERTIARY CARE CENTRES IN SOUTH INDIA

Abstract

Aim: To study the clinical manifestations and treatment outcomes of COVID-19 related multisystem inflammatory syndrome in children (MIS-C) and adolescents. Method(s): It was a cohort study including cases defined as per the case definitions of MIS-C by the World Health Organisation (WHO) or Centre for Disease Control and Prevention (CDC). The clinical parameters, laboratory parameters, 2D echocardiogram, course in hospital, and immediate outcomes were noted. Result(s): We report on 25 patients with MIS-C in south India. The mean age of onset was 6.22 +/- 4.25 years, 14 patients (56%) were male, the mean body mass index (BMI) was 16.21 +/- 3.36, and 24 patients (96%) were positive for COVID19 antibodies. The most common symptoms were fever in 24 patients (96%), fatigue/myalgia in 20 patients (80%), and conjunctivitis in 18 patients (72%). Out of 25 patients, 18 (72%) had a phenotype of incomplete/ atypical Kawasaki Disease, 11(44%) had macrophage activation syndrome, 13(52%) had an unexplained shock, 17(68%) had fever with gastrointestinal symptoms, 9(36%) had fever with neurological symptoms and 5(20%) had fever with respiratory symptoms. The mean duration of hospital stay was 8.12 +/- 5.76 days; 20 patients (80%) required intensive care, 14 patients (56%) required ionotropic agents, 8 patients (32%) required supplemental oxygen, 5 patients (20%) required mechanical ventilation and 2 patients (8%) died. Coronary artery dilation /non-tapering prominent coronaries were noted in 9 patients (36%) and abnormal echocardiography findings were noted in 15 patients (60%). Most patients had elevated inflammatory biomarkers. Twenty-three patients (92%) received steroids and 22 patients (88%) received IVIG (2g/kg). Conclusion(s): Our MIS-C cohort had varied clinical manifestations ranging from mild cutaneous and gastrointestinal symptoms to fatal multiorgan dysfunctions. In contrast to western cohorts, our study cohort had a higher number of patients from the younger age group and lower BMI.