Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syn
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RESEARCH
Severe manifestations of SARS‑CoV‑2 in children and adolescents: from COVID‑19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain Alberto García‑Salido1†, Juan Carlos de Carlos Vicente2†, Sylvia Belda Hofheinz3, Joan Balcells Ramírez4, María Slöcker Barrio5, Inés Leóz Gordillo1, Alexandra Hernández Yuste6, Carmina Guitart Pardellans7, Maite Cuervas‑Mons Tejedor8, Beatriz Huidobro Labarga9, José Luís Vázquez Martínez10, Míriam Gutiérrez Jimeno11, Ignacio Oulego‑Erróz12, Javier Trastoy Quintela13, Carmen Medina Monzón14, Laura Medina Ramos15, María Soledad Holanda Peña16, Javier Gil‑Antón17, Clara Sorribes Ortí18, José Carlos Flores González19, Rosa María Hernández Palomo20, Inma Sánchez Ganfornina21, Emilia Fernández Romero22, María García‑Besteiro23, Jesús López‑Herce Cid5, Rafael González Cortés5* and the Spanish Pediatric Intensive Care Society working group on SARS-CoV-2 infection
Abstract Background: Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admit‑ ted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods: A multicentric prospective national registry including 47 PICUs was carried out. Data from children admit‑ ted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results: Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5–11.8) vs 3.4 years (IQR 0.4–9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more fre‑ quently with respiratory distress (60.7% vs 13.3%, p
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