Literature DB >> 33872279

Multisystem Inflammatory Syndrome in Infants <12 months of Age, United States, May 2020-January 2021.

Shana Godfred-Cato1, Clarisse A Tsang1, Jennifer Giovanni1, Joseph Abrams1, Matthew E Oster1, Ellen H Lee2, Maura K Lash2, Chloe Le Marchand3, Caterina Y Liu3, Caitlin N Newhouse4, Gillian Richardson5, Meghan T Murray6, Sarah Lim7, Thomas E Haupt8, Amanda Hartley9, Lynn E Sosa10, Kompan Ngamsnga11, Ali Garcia12, Deblina Datta1, Ermias D Belay1.   

Abstract

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C), temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been identified in infants <12 months old. Clinical characteristics and follow-up data of MIS-C in infants have not been well described. We sought to describe the clinical course, laboratory findings, therapeutics and outcomes among infants diagnosed with MIS-C.
METHODS: Infants of age <12 months with MIS-C were identified by reports to the CDC's MIS-C national surveillance system. Data were obtained on clinical signs and symptoms, complications, treatment, laboratory and imaging findings, and diagnostic SARS-CoV-2 testing. Jurisdictions that reported 2 or more infants were approached to participate in evaluation of outcomes of MIS-C.
RESULTS: Eighty-five infants with MIS-C were identified and 83 (97.6%) tested positive for SARS-CoV-2 infection; median age was 7.7 months. Rash (62.4%), diarrhea (55.3%) and vomiting (55.3%) were the most common signs and symptoms reported. Other clinical findings included hypotension (21.2%), pneumonia (21.2%) and coronary artery dilatation or aneurysm (13.9%). Laboratory abnormalities included elevated C-reactive protein, ferritin, d-dimer and fibrinogen. Twenty-three infants had follow-up data; 3 of the 14 patients who received a follow-up echocardiogram had cardiac abnormalities during or after hospitalization. Nine infants had elevated inflammatory markers up to 98 days postdischarge. One infant (1.2%) died after experiencing multisystem organ failure secondary to MIS-C.
CONCLUSIONS: Infants appear to have a milder course of MIS-C than older children with resolution of their illness after hospital discharge. The full clinical picture of MIS-C across the pediatric age spectrum is evolving.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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Year:  2021        PMID: 33872279      PMCID: PMC8408805          DOI: 10.1097/INF.0000000000003149

Source DB:  PubMed          Journal:  Pediatr Infect Dis J        ISSN: 0891-3668            Impact factor:   2.129


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