COVID Multisystem Inflammatory Syndrome in Children (MIS-C): The Northern NJ Experience

Background: Coronavirus disease (COVID-19) caused by SARS-COV2 represents global public health concern, with varied severity of illness in different ages and racial groups. This study aims to describe clinical presentation and outcomes of children aged 0-21 years diagnosed with MIS-C in a community hospital setting in the United States.

Methods: This is a retrospective medical record review of pediatric patients admitted to the ICU with confirmed diagnosis of MIS-C.

Results: We identified 24 cases of MIS-C at two community hospitals during period of March 2020- June 2021.

Fever (92%) and nausea/vomiting (79%) were the most frequent symptoms identified, followed by red eyes (54%) and rash (54%). Additional symptoms included diarrhea (46%), abdominal pain (46%), headache (42%), shortness of breath (13%), myalgia (13%), and chest pain (4%).

Of the 24 patients, 15 (63%) were male, and 9 (37%) were female. Race and ethnic distribution was African American/Black (66%), Hispanic origin (29%) and Other/not reported (4%). The majority of patients were aged 6-10 years (38%), followed by 1-5 years (25%) and 11-15 years (25%), and over 15 years (12%). Echocardiogram findings showing decreased cardiac function and/or pericardial effusion was found in 38% of patients, with complete recovery of cardiac function in 100%. Management included IVIG administration (92%), with 4 patients requiring second dose, and 1 patient also requiring Anakinra. Additional treatment included steroids (92%) and aspirin (96%). Two patients received Lovenox.

Conclusion: As shown in various other studies, minorities seem to be disproportionately impacted and prompt recognition of clinical presentation and management is critical for this population. Ongoing longitudinal studies are needed to determine factors affecting why certain ethnicities are impacted more than others.