الفهرس 
Introduction & Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Children with COVID-19 may develop a disorder called MIS-C, which causes inflammation in many different parts of the body. MIS-actual C’s worldwide prevalence is unknown at this time [184]. The Centers for Disease Control and Prevention (CDC) defines MIS-C as an extremely serious disease related with COVID-19 in children [107].
The purpose of this investigation was to assess the neurological symptoms experienced by paediatric patients diagnosed with MIS-C due to COVID-19. In order to do this, a prospective and retrospective study was done on 303 patients hospitalised to the PICU isolation unit at Minia University Hospital between December 2020 and April 2022. Patients were divided into three categories based on their PCR results: group I (MIS-C, PCR positive) contained 60 patients, group II (MIS-C, PCR negative) included 187 patients, and group III (Non-MIS-C, PCR positive) included 56 patients.
Most importantly, this study’s results indicated that:
There were no statistically significant variations in age, body mass index, or country of residence between the two groups. There were no statistically significant differences between the sexes, however men showed up more often than women in the clinical trials.
group (I) (93.3%), group (II) (96.3%), and group (III) (83.9%) had substantially more respiratory symptoms than group (III) (82.9%). However, group (I) and group (II) did not vary significantly from one another (II).
group (II) had considerably more patients without cardiovascular symptoms (163) compared to group (I) (42-70%), whereas group (III) had no instances with cardiovascular symptoms.
group (II) (100) showed a substantially higher prevalence of neurologic symptoms than group (I) (27) and group (III) (8) (14.3%).
group (II) (80) showed considerably higher rates of GI symptoms than group (I) (18%) and group (III) (1%) overall.
There was a statistically significant increase in the prevalence of hematologic symptoms among Groups II and I compared to group III, where none of the patients exhibited any of these symptoms (p0.01).
Patients in group (I) and group (II) had renal and dermatologic complaints in very low numbers. Although group (III) had no renal or dermatologic complaints, this was not statistically different from Groups I and II.
Among group (I), 19 (31.7%) had convulsions, 17 (28.3%) DCL, and 15 (25.0%) displayed headache and weakness. group (II) (41; 21.9%) showed considerably higher signs of tiredness.
However, group 2 showed a trend toward increased irritation without reaching statistical significance (II). group 2 had a trend toward more frequent displays of hypertonia, hyperreflexia, hypotonia, and hyporeflexia, but these differences were not statistically significant (I). group 2 patients did not exhibit ataxia, nystagmus, hallucinations, or lethargy, but group 1 patients did (II).
TLC, PLT, and Neutrophils (%) CBC measurements indicated no statistically significant variation between groups.
Mean SD Lymphocytes (%) for group I (17.5 2.4) and group II (18.9 1.8) were significantly lower than for group III (21.4 1.8), p 0.01.
group (I) had the lowest albumin levels (Mean SD: 3.2 0.4, Range: 3.0-3.7 mg/dl) compared to Groups (II) and (III), where albumin levels were (respectively) 3.4 0.5, Range: 3.1-4.1 mg/dl and 3.5 0.5, Range: 3.1-4.0 mg/dl. However, there was no statistically significant difference in PC levels between the groups.
When comparing the three groups, group I had the highest CRP levels (Mean SD: 95.4 7.8; Range: 21-128 mg/L), group II had the second highest (Mean SD: 85.6 9.7; Range: 21-96 mg/L), and group III had the lowest (Mean SD: 63.8 6.9; Range: 12-96 mg/L), p 0.01.
D-dimer levels were also substantially higher in group (I) than in Groups (II) and (III) (Mean SD is 3.7 0.8 with a range of 1-7.6 (109/L) and 3.9 1.0 with a range of 1-8.4 (109/L), respectively), p-value 0.01).
S. group (I) had the highest ferritin levels (Mean SD = 395 54.2, Range = 196-982 g /L), group (II) had the second highest ferritin levels (Mean SD = 379 41.5, Range = 205-854 g /L), and group (III) had the lowest ferritin levels (Mean SD = 349 35.4, Range = 178-784
There was no statistically significant difference between the groups in terms of LDH or ESR levels.
Patients in group (I) had the highest troponin levels (Mean SD is 0.55 0.18 with a range of 0.1-1.1 ng/mL), whereas patients in group (II) had the lowest (Mean SD is 0.33 0.11 with a range of 0.1-0.6 ng/mL), p-value 0.01.
For the CPK, there was no statistically significant difference between the groups.
There was no statistically significant difference between the groups in terms of the proportion of individuals with normal and abnormal results on CT scans of the chest, brain, and spine; however, abnormal results on CT scans of the chest and brain were more prevalent in group (I), and abnormal results on MRI scans of the brain were more prevalent in group (II) (III).
group III (20, 35.7%) had a significantly higher proportion of patients with Echo abnormalities compared to group II (30, 16%) or group I (8, 13.3%), as shown by the data. In addition, group (II) had considerably more cases of aberrant Abdominal Ultrasound signs than group (I) had (24(12.8%) vs 4(6.7%) and 1(1.8%), respectively).
Patients in all three groups had abnormal Chest CT findings, with ground glass opacities (CO-RADS III) being the most common (44/73.3%, 149/79.7%, 42/75%) in group (I), group (II), and group (III), respectively. This was followed by (CO-RADS IV) (11/18.3%, 19/10.2%, 4/7.1%) and (CO-RADS V) (1/1.7%), 4/2.1%), and 1/1.8
More patients in group III (83.9%) had normal Brain CT scans than in any of the other groups (80.7%), followed by those in group II (80.7%) and group I (48.0%). There was higher evidence of cerebral edoema in group (I), whereas group (II) patients showed more signs of intracerebral haemorrhage (III). Only those in group 1 had signs of cerebral venous sinus thrombosis and cerebral infarction (II).
Patients in group (I) had a substantially longer hospital stay (Mean SD: 7.8 2.1, Range: 6-11 Days) than those in Groups (II) and (III) (Mean SD: 6.9 2.4, Range: 5-10 Days) and group (III) (Mean SD: 4.2 1.3, Range: 3-8 Days).
In terms of survival rates, group (I) had a far higher proportion of patients who did not make it than Groups (II) and (III) (8.1% and 10.7%, respectively).
Concerning the results seen in people who have neurological symptoms. There were more patients who did not make it in Groups I and II (12 (44.4%) and 41 (41.0%), respectively) than there were in group III (1(12.5%).