Severity predictors for multisystemic inflammatory syndrome in children after SARS-CoV-2 infection in Vietnam

Multisystemic inflammatory syndrome in children (MIS-C) might manifest in a broad spectrum of clinical scenarios, ranging from mild features to multi-organ dysfunction and mortality. However, this novel entity has a heterogenicity of data regarding prognostic factors associated with severe outcomes....

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Published in:	Scientific reports Vol. 14; no. 1; pp. 15810 - 10
Main Authors:	Tran, Dien. M., Pham, Dem. V., Cao, Tung. V., Hoang, Canh. N., Nguyen, Ha. T. T., Nguyen, Giang. D., Le, Cuong. N., Thieu, Quan. Q., Ta, Tuan. A., Dau, Hung. V., Le, Chi. Q., Le, Quang. H., Luong, Nghiem. T., Tran, Mai. T., Nguyen, Phu. H., Nguyen, Nhung. T., Phan, Phuc. H.
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 09-07-2024 Nature Publishing Group Nature Portfolio
Subjects:	692/1807 692/308 692/499 692/699 692/700 Adolescent Albumin C-Reactive Protein - analysis C-Reactive Protein - metabolism Cell number Child Child, Preschool Children Comorbidity COVID-19 - complications COVID-19 - diagnosis COVID-19 - epidemiology Female Ferritin Humanities and Social Sciences Humans Infant Inflammation Intensive Care Units, Pediatric Lymphocyte Count Lymphocytes Male MIS-C multidisciplinary Multisystemic inflammatory syndrome in children Patients Prognosis Regression analysis Risk groups SARS-CoV-2 SARS-CoV-2 - isolation & purification Science Science (multidisciplinary) Severe acute respiratory syndrome coronavirus 2 Severity Severity of Illness Index Shock Systemic Inflammatory Response Syndrome - diagnosis Systemic Inflammatory Response Syndrome - epidemiology Vietnam - epidemiology Vietnam Multisystemic inflammatory syndrome in children Shock MIS-C SARS-CoV-2 Severity
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Summary:	Multisystemic inflammatory syndrome in children (MIS-C) might manifest in a broad spectrum of clinical scenarios, ranging from mild features to multi-organ dysfunction and mortality. However, this novel entity has a heterogenicity of data regarding prognostic factors associated with severe outcomes. The present study aimed to identify independent predictors for severity by using multivariate regression models. A total of 391 patients (255 boys and 136 girls) were admitted to Vietnam National Children’s Hospital from January 2022 to June 2023. The median age was 85 (range: 2–188) months, and only 12 (3.1%) patients had comorbidities. 161 (41.2%) patients required PICU admission, and the median PICU LOS was 4 (2–7) days. We observed independent factors related to PICU admission, including CRP ≥ 50 (mg/L) (OR 2.52, 95% CI 1.39–4.56, p = 0.002), albumin ≤ 30 (g/L) (OR 3.18, 95% CI 1.63–6.02, p = 0.001), absolute lymphocyte count ≤ 2 (× 10 9 /L) (OR 2.18, 95% CI 1.29–3.71, p = 0.004), ferritin ≥ 300 (ng/mL) (OR 2.35, 95% CI 1.38–4.01), p = 0.002), and LVEF < 60 (%) (OR 2.48, 95% CI 1.28–4.78, p = 0.007). Shock developed in 140 (35.8%) patients, especially for those decreased absolute lymphocyte ≤ 2 (× 10 9 /L) (OR 2.48, 95% CI 1.10–5.61, p = 0.029), albumin ≤ 30 (g/L) (OR 2.53, 95% CI 1.22–5.24, p = 0.013), or LVEF < 60 (%) (OR 2.24, 95% CI 1.12–4.51, p = 0.022). In conclusion, our study emphasized that absolute lymphocyte count, serum albumin, CRP, and LVEF were independent predictors for MIS-C severity. Further well-designed investigations are required to validate their efficacy in predicting MIS-C severe cases, especially compared to other parameters. As MIS-C is a new entity and severe courses may progress aggressively, identifying high-risk patients optimizes clinicians' follow-up and management to improve disease outcomes.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-024-66891-4