tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2021 Apr 16.
doi: 10.1097/INF.0000000000003149. Online ahead of print.
Multisystem Inflammatory Syndrome in Infants <12 months of Age, United States, May 2020-January 2021
Shana Godfred-Cato[SUP] 1 [/SUP], Clarisse A Tsang, Jennifer Giovanni, Joseph Abrams, Matthew E Oster, Ellen H Lee, Maura K Lash, Chloe Le Marchand, Caterina Y Liu, Caitlin N Newhouse, Gillian Richardson, Meghan T Murray, Sarah Lim, Thomas E Haupt, Amanda Hartley, Lynn E Sosa, Kompan Ngamsnga, Ali Garcia, Deblina Datta, Ermias D Belay
Affiliations
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.
. 2021 Apr 16.
doi: 10.1097/INF.0000000000003149. Online ahead of print.
Multisystem Inflammatory Syndrome in Infants <12 months of Age, United States, May 2020-January 2021
Shana Godfred-Cato[SUP] 1 [/SUP], Clarisse A Tsang, Jennifer Giovanni, Joseph Abrams, Matthew E Oster, Ellen H Lee, Maura K Lash, Chloe Le Marchand, Caterina Y Liu, Caitlin N Newhouse, Gillian Richardson, Meghan T Murray, Sarah Lim, Thomas E Haupt, Amanda Hartley, Lynn E Sosa, Kompan Ngamsnga, Ali Garcia, Deblina Datta, Ermias D Belay
Affiliations
- PMID: 33872279
- DOI: 10.1097/INF.0000000000003149
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.