Multicentre observational study on multisystem inflammatory syndrome related to COVID ‐19 in Argentina

VAINSTEIN, EDUARDO; BALEANI, SILVIA; URRUTIA, LUIS; AFFRANCHINO, NICOLÁS; ACKERMAN, JUDITH; CAZALAS, MARIANA; GOLDSMAN, ALEJANDRO; SARDELLA, ANGELA; TOLIN, ANA LAURA; GOLDARACENA, PABLO; FABI, MARIANA; COSENTINO, MARIANA; MAGLIOLA, RICARDO; ROGGIERO, GUSTAVO; MANSO, PAULA; TRIGUY, JÉSICA; BALLESTER, CELESTE; CERVETTO, VANESA; VACCARELLO, MARÍA; DE CARLI, DOMINGO NORBERTO; DE CARLI, MARIA ESTELA; CIOTTI, ANA LAURA; SICURELLO, MARÍA IRENE; RÍOS LEIVA, CECILIA; VILLALBA, CLAUDIA; HORTAS, MARÍA; PEÑA, SONIA; GONZÁLEZ, GABRIELA; ZOLD, CAMILA LIDIA; MURER, MARIO GUSTAVO; EMSKC GROUP

PEDIATRICS INTERNATIONAL

WILEY-BLACKWELL PUBLISHING, INC

Lugar: Londres; Año: 2023

1328-8067

Background: The impact of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in low- and middle-income countries remains poorly understood. Our aim was to understand the characteristics and outcomes of PIMS-TS in Argentina.Methods: This observational, prospective, and retrospective multicenter study enrolled patients younger than 18 years-old manifesting PIMS-TS, Kawasaki disease (KD) or Kawasaki shock syndrome (KSS) between March 2020 and May 2021. Patients were followed-up until hospital discharge or death (one case). The primary outcome was pediatric intensive care unit (PICU) admission. Multiple logistic regression was used to identify variables predicting PICU admission.Results: Eighty-one percent, 82%, and 14% of the 176 enrolled patients fulfilled the suspect case criteria for PIMS-TS, KD, and KSS, respectively. Temporal association with SARS-CoV-2 was confirmed in 85% of the patients and 38% were admitted to the PICU. The more common clinical manifestations were fever, abdominal pain, rash, and conjunctival injection. Lymphopenia was more common among PICU-admitted patients (87% vs. 51%, p < 0.0001), who also showed a lower platelet count and higher plasmatic levels of inflammatory and cardiac markers. Mitral valve insufficiency, left ventricular wall motion alterations, pericardial effusion, and coronary artery alterations were observed in 30%, 30%, 19.8%, and 18.6% of the patients, respectively. Days to initiation of treatment, rash, lymphopenia, and low platelet count were significant independent contributions to PICU admission.Conclusion: Rates of severe outcomes of PIMS-TS in the present study agreed with those observed in high-income countries. Together with other published studies, this work helps clinicians to better understand this novel clinical entity.Keywords: COVID-19; Kawasaki disease; Kawasaki shock syndrome; multisystem inflammatory syndrome in children; pediatric multisystem inflammatory syndrome.