Department of Paediatrics and Child Health

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Browsing Department of Paediatrics and Child Health by browse.metadata.advisor "Abraham, Deepthi Raju"

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    Short-term outcomes of children with multisystem inflammatory syndrome in children (MIS-C) in South Africa : a prospective cohort study
    (Stellenbosch : Stellenbosch University, 2023-03) Lishman, Juanita; Rabie, Helena; Abraham, Deepthi Raju; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.
    ENGLISH SUMMARY: Background: Despite the life-threatening presentation of MISC in children, the overall prognosis is favourable in centers with access to appropriate supportive care. In this study we investigate the short-term outcomes in children with MIS-C in Cape Town, South Africa. Methods: This prospective observational cohort study in children <13 years who fulfilled the World Health Organization (WHO) case definition of MIS-C and were admitted to Tygerberg Hospital in Cape Town between 1 June 2020 and 31 October 2021. Clinical features were recorded at baseline and at followup at cardiology and rheumatology-immunology clinics respectively. Findings: Fifty-three children with a median age of 7.4 years (interquartile range (IQR) 4.2-9.9) MIS-C were included. There was a slight male predominance (30/53; 56,6%) and the majority was of mixed-race (28/53; 52,83%) or black African ancestry (24/53; 45,3%). Fourteen children (14/53; 26,4%) had comorbid disease. The median length of hospital stay was 8 days (IQR 6-10). All children had an echocardiogram performed at baseline of which 39 were abnormal (39/53; 73,6%). The majority had elevated markers of inflammation, lymphopenia, anaemia, renal impairment, hyponatremia, and elevated cardiac enzymes during the acute phase. All children were discharged alive. The median days from discharge to cardiology follow-up was 39 days (IQR 33.5-41.5) and for rheumatology immunology clinic was 70.5 days (IQR 59.5-85.0). Eleven children (11/41; 26,8%) had a persistently abnormal echocardiogram at cardiology follow-up. Systemic inflammation and organ dysfunction resolved in most. Interpretation: Although the short-term outcomes of MIS-C in our cohort were generally good, the cardiac morbidity needs further characterization and follow-up.