الفهرس 
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Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections may result in multisystem inflammatory syndrome in children (MIS-C). The clinical presentation of MIS-C includes fever, severe illness, and the involvement of two or more organ systems, in combination with laboratory evidence of inflammation and laboratory or epidemiologic evidence of SARS-CoV-2 infection. The relationship of MIS-C to SARS-CoV-2 infection suggests that the pathogenesis involves post-infectious immune deregulation.
This study was designed to follow up with children who recovered MIS-C associated with SARS-COV2 infection to determine any squeal or delayed manifestation of MIS-c.
This study was done at the pediatric intensive care unit at Beni-Suef University hospital from March to July 2020. It included 53 patients who met the criteria for MIS-C with an average age of 5.08 ±4.05 year.
All patients included in the study were subjected to full clinical assessment and investigations including CBC, CRP, Ferritin, D-dimer Anti-SARS-CoV-2 IgM, IgG, and COVID PCR. In addition, baseline CT chest, Echo, and other imaging parameters were done. The assessment was done on admission and followed up every month for 3-4 month. The results of the following study revealed the following:
Fever was a universal finding. The hematological system was the most affected system followed by both GIT and neurological systems.
24.53% of patients presented with Kawasaki-like symptoms 30.2% of patients had echocardiographic abnormalities.
Most patients had positive IgG antibodies while 15.1% of patients had positive IgM antibodies and PCR.
Most patients had severe MIS-C and required intensive care admission. 22.6% of patients required mechanical ventilation, and 52.8% required inotropes. 94.3% of patients were treated with intravenous immunoglobulin, and 98.1% of patients were treated with steroids.
The mortality was 22.6% and it was significantly correlated with younger ages less than 6 months, low body weight, and chronic illness, especially CKD. It was significantly higher among children with MIS-C clinical presentation overlapping with COVID-19 infection.
Lymphopenia and thrombocytopenia were more common among dead than survivor children.
Before discharge, inflammatory markers improved. During follow-up, most of the clinical symptoms improved except mild symptoms such as fatigue, palpitation, anxiety, and depression. All patients presented with echo abnormalities became normal within 4 weeks except one patient with mild coronary dilatation persistent after 4 months.