Characteristics and Outcomes of Critically Ill Children With Multisystem Inflammatory Syndrome. Pediatr Crit Care Med 2022 Nov 01;23(11):e530-e535
Date
08/23/2022Pubmed ID
35994614Pubmed Central ID
PMC9624236DOI
10.1097/PCC.0000000000003054Scopus ID
2-s2.0-85141690218 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
OBJECTIVES: To characterize the prevalence of pediatric critical illness from multisystem inflammatory syndrome in children (MIS-C) and to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain on outcomes.
DESIGN: Retrospective cohort study.
SETTING: Database evaluation using the Virtual Pediatric Systems Database.
PATIENTS: All children with MIS-C admitted to the PICU in 115 contributing hospitals between January 1, 2020, and June 30, 2021.
MEASUREMENTS AND MAIN RESULTS: Of the 145,580 children admitted to the PICU during the study period, 1,338 children (0.9%) were admitted with MIS-C with the largest numbers of children admitted in quarter 1 (Q1) of 2021 ( n = 626). The original SARS-CoV-2 viral strain and the D614G Strain were the predominant strains through 2020, with Alpha B.1.1.7 predominating in Q1 and quarter 2 (Q2) of 2021. Overall, the median PICU length of stay (LOS) was 2.7 days (25-75% interquartile range [IQR], 1.6-4.7 d) with a median hospital LOS of 6.6 days (25-75% IQR, 4.7-9.3 d); 15.2% received mechanical ventilation with a median duration of mechanical ventilation of 3.1 days (25-75% IQR, 1.9-5.8 d), and there were 11 hospital deaths. During the study period, there was a significant decrease in the median PICU and hospital LOS and a decrease in the frequency of mechanical ventilation, with the most significant decrease occurring between quarter 3 and quarter 4 (Q4) of 2020. Children admitted to a PICU from the general care floor or from another ICU/step-down unit had longer PICU LOS than those admitted directly from an emergency department.
CONCLUSIONS: Overall mortality from MIS-C was low, but the disease burden was high. There was a peak in MIS-C cases during Q1 of 2021, following a shift in viral strains in Q1 of 2021. However, an improvement in MIS-C outcomes starting in Q4 of 2020 suggests that viral strain was not the driving factor for outcomes in this population.
Author List
Snooks K, Scanlon MC, Remy KE, Shein SL, Klein MJ, Zee-Cheng J, Rogerson CM, Rotta AT, Lin A, McCluskey CK, Carroll CLAuthors
Matthew C. Scanlon MD Professor in the Pediatrics department at Medical College of WisconsinKellie C. Snooks DO Assistant Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
ChildCritical Illness
Humans
Intensive Care Units, Pediatric
Retrospective Studies
Systemic Inflammatory Response Syndrome