Shreepal Jain1, Supratim Sen2, Srinivas Lakshmivenkateshiah3, Prashant Bobhate4, Sumitra Venkatesh1, Soonu Udani5, Laxmi Shobhavat1, Parmanand Andankar3, Tanuja Karande4, Snehal Kulkarni4. 1. Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India. 2. SRCC Children's Hospital, Mumbai, Maharashtra, India. Correspondence to: Dr Supratim Sen, Department of Pediatric Cardiology, SRCC Children's Hospital, Mahalaxmi, Mumbai 400034, Maharashtra, India. supratim80@gmail.com. 3. Jupiter Hospital, Thane, Maharashtra, India. 4. Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India. 5. SRCC Children's Hospital, Mumbai, Maharashtra, India.
Abstract
OBJECTIVE: We describe the presentation, treatment and outcome of children with multisystem inflammatory syndrome with COVID-19 (MIS-C) in Mumbai metropolitan area in India. METHOD: This is an observational study conducted at four tertiary hospitals in Mumbai. Parameters including demographics, symptomatology, laboratory markers, medications and outcome were obtained from patient hospital records and analyzed in patients treated for MIS-C (as per WHO criteria) from 1 May, 2020 to 15 July, 2020. RESULTS: 23 patients (11 males) with median (range) age of 7.2 (0.8-14) years were included. COVID-19 RT-PCR or antibody was positive in 39.1% and 30.4%, respectively; 34.8% had a positive contact. 65% patients presented in shock; these children had a higher age (P=0.05), and significantly higher incidence of myocarditis with elevated troponin, NT pro BNP and left ventri-cular dysfunction, along with significant neutrophilia and lympho-penia, as compared to those without shock. Coronary artery dilation was seen in 26% patients overall. Steroids were used most commonly for treatment (96%), usually along with intra-venous immunoglobulin (IVIg) (65%). Outcome was good with only one death. CONCLUSION: Initial data on MIS-C from India is presented. Further studies and longer surveillance of patients with MIS-C are required to improve our diagnostic, treatment and surveillance criteria.
OBJECTIVE: We describe the presentation, treatment and outcome of children with multisystem inflammatory syndrome with COVID-19 (MIS-C) in Mumbai metropolitan area in India. METHOD: This is an observational study conducted at four tertiary hospitals in Mumbai. Parameters including demographics, symptomatology, laboratory markers, medications and outcome were obtained from patient hospital records and analyzed in patients treated for MIS-C (as per WHO criteria) from 1 May, 2020 to 15 July, 2020. RESULTS: 23 patients (11 males) with median (range) age of 7.2 (0.8-14) years were included. COVID-19 RT-PCR or antibody was positive in 39.1% and 30.4%, respectively; 34.8% had a positive contact. 65% patients presented in shock; these children had a higher age (P=0.05), and significantly higher incidence of myocarditis with elevated troponin, NT pro BNP and left ventri-cular dysfunction, along with significant neutrophilia and lympho-penia, as compared to those without shock. Coronary artery dilation was seen in 26% patients overall. Steroids were used most commonly for treatment (96%), usually along with intra-venous immunoglobulin (IVIg) (65%). Outcome was good with only one death. CONCLUSION: Initial data on MIS-C from India is presented. Further studies and longer surveillance of patients with MIS-C are required to improve our diagnostic, treatment and surveillance criteria.
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