New Clues to Which Children May Be Headed for MIS-C—and Poor Outcomes

Parents and caregivers took some small degree of comfort as COVID-19 surged in “knowing” that the virus didn’t pose much of a risk to children—or so the thinking went at the time. Since then, we’ve become acquainted with multisystem inflammatory syndrome in children (MIS-C), a related illness that does seem to pose a greater risk in younger patients. A new article published in Morbidity and Mortality Weekly Report reveals characteristics of MIS-C that could be helpful to urgent care providers in understanding course of disease and identifying children who may be a higher risk. The data are drawn from a study of 570 MIS-C patients with onset dates between March 2 and July 18, 2020 as reported by 40 state health departments, the District of Columbia, and New York City. Median age of the patients was 8 years; 55% were male. Around two thirds did not have any preexisting, underlying conditions before their diagnosis; the most common underlying condition, obesity, was present in 26% of the patients. The vast majority (86%) of cases involved at least four organ systems. All of the  99% who had a SARS-CoV-2 test were positive by reverse transcription–polymerase chain reaction or serology. The most common severe complications were cardiac dysfunction (41%), shock (35%), myocarditis (23%), coronary artery dilatation or aneurysm (19%), and acute kidney injury (18%). Most patients (63.9%) were admitted to an ICU, with a median length of stay of 5 days. Ten of the patients died. Click here to read the report in its entirety.