Multisystem Inflammatory Syndrome in Children With COVID-19 in Mumbai, India
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Multisystem Inflammatory Syndrome in Children With COVID-19 in Mumbai, India SHREEPAL JAIN,1 SUPRATIM SEN,2 SRINIVAS LAKSHMIVENKATESHIAH,3 PRASHANT BOBHATE,4 SUMITRA VENKATESH,1 SOONU UDANI,2 LAXMI SHOBHAVAT,1 PARMANAND ANDANKAR,3 TANUJA KARANDE4 AND SNEHAL KULKARNI4 1Bai Jerbai Wadia Hospital for Children, Mumbai; 2SRCC Children’s Hospital, Mumbai; 3Jupiter Hospital, Thane; 4Kokilaben Dhirubhai Ambani Hospital, Mumbai; Maharashtra, India. Correspondence to: Dr Supratim Sen, Department of Pediatric Cardiology, SRCC Children’s Hospital, Mahalaxmi, Mumbai 400034, Maharashtra, India. [email protected] Received: July 20, 2020; Initial review: August 04, 2020; Accepted: August 09, 2020.
Objective: We describe the presentation, treatment and outcome of children with multisystem inflammatory syndrome with COVID-19 (MIS-C) in Mumbai metropolitan area in India. Methods: This is an observational study conducted at four tertiary hospitals in Mumbai. Parameters including demographics, symptomatology, laboratory markers, medications and outcome were obtained from patient hospital records and analyzed in patients treated for MIS-C (as per WHO criteria) from 1 May, 2020 to 15 July, 2020. Results: 23 patients (11 males) with median (range) age of 7.2 (0.8-14) years were included. COVID-19 RT-PCR or antibody was positive in 39.1% and 30.4%, respectively; 34.8% had a positive contact. 65% patients presented in shock; these children
had a higher age (P=0.05), and significantly higher incidence of myocarditis with elevated troponin, NT pro BNP and left ventricular dysfunction, along with significant neutrophilia and lymphopenia, as compared to those without shock. Coronary artery dilation was seen in 26% patients overall. Steroids were used most commonly for treatment (96%), usually along with intravenous immunoglobulin (IVIg) (65%). Outcome was good with only one death. Conclusion: Initial data on MIS-C from India is presented. Further studies and longer surveillance of patients with MIS-C are required to improve our diagnostic, treatment and surveillance criteria. Keywords: PIMS-TS, Kawasaki disease, Myocarditis, COVID19, SARS-CoV-2. Published Online: August 11, 2020; PII: S097475591600230
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ultisystem inflammatory syndrome in children (MIS-C) associated with COVID19 [1,2], also called as Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) [3], is a hyperinflammatory syndrome occurring in close temporal association with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children. The initial cases from India were reported in May, 2020 [46], and as the number of COVID-19 cases has grown exponentially across the country, clinicians have started identifying this new entity more frequently [7]. We describe clinical features and management in children with MIS-C from the Mumbai metropolitan area, which had a high incidence of coronavirus disease 2019 (COVID-19). METHODS This is the preliminary analysis of an ongoing observational study from the Division of pediatric
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