Abstract

A novel coronavirus identified in late 2019 which later reached pandemic status named as covid-19. In children covid-19 is usually mild except for few cases. In April 2020 many cases were reported in children with features similar to Kawasaki disease or toxic shock syndrome and the condition later termed as multisystem inflammatory syndrome in children (MISC) or paediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2(PIMS-TS). Objective: To know the clinical presentation of MISC and to know the laboratory profile and outcome in MISC. Material and Methods: This is a retrospective study conducted in Gadag institute of medical sciences from April 2021 to September 2021.consecutive cases admitted and treated as MISC were included and studied for clinical profile, laboratory investigations, complications, treatment received and outcome. Results: Total of 30 patients were included in the study fulfilling WHO criteria for MISC with mean age of 5 years and females more affected than males(1:1.5). fever was the major symptom present in all the patients, gastrointestinal symptoms were common(70%) followed by respiratory symptoms and mucocutaneous symptoms and CNS symptoms. Most common sign was respiratory distress(46%) followed by shock, acute kidney injury, encephalopathy and myocardial dysfunction. 3 cases were diagnosed as complete KD phenotype. CRP was elevated inmost all the patients(100%) followed by D-Dimer (73%), ferritin (56%),procalcitonin (53%) and LDH (26%). Coagulation profile was deranged in 43%(n-13) and troponin was elevated in 2 patients (6%). Most of the patients received steroids and few were treated with IVIG and aspirin. 2 patients were diagnosed of having coronary artery dilatation on 2D-ECHO and 2 of the 30 have died during the hospital course. Conclusion: though covid-19 is less severe in children, post covid inflammatory response is seen in children which was similar to KD. MISC presents with features involving multiple systems with range of clinical features and signs sometimes with life threatening complications like shock and respiratory distress. It usually has a good prognosis with early identification and correct treatment.

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