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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2020, Number 2

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Bol Clin Hosp Infant Edo Son 2020; 37 (2)

Multisystemic inflammatory syndrome in children (MIS-C) by SARS-CoV-2. Experience of a second level Hospital in Tijuana, Baja California, Mexico

Aquino-Villagómez DY, Pila-Aranda G, González-Agosto A, Anzaldo-Campos MC, Pasarín-Montes JL, Martínez-Arce PA, Reyes-Hernández KL, Soria-Saavedra F, Candelas-Delgado E, Virgen-Ortega C, Reyes-Gómez U

Language: Spanish
References: 29
Page: 78-86
PDF size: 203.37 Kb.


ABSTRACT

A temporary association between SARS-CoV-2 and late inflammatory systemic manifestations in previously healthy pediatric patients has recently been found that could be due to post-viral immunological reactions called Multisystem inflammatory syndrome in children (MIS-C). Descriptive, observational, transversal study it was carried out from May 29 to July 12, 2020 in a second level Hospital in the city of Tijuana, Baja California, Mexico. We included all children and adolescents (aged ≤18 years) who met the criteria for MIS-C according to the CDC. 6 patients were studied, in 5 (83%) reported exposure to COVID-19 within 4 weeks prior to the onset of symptoms, the median age was 5.3 years, male predominance of 5: 1, all of Hispanic ethnicity, without predominance of the purse group, with an average of 2.8 days of symptoms prior to admission. 100% had a fever of more than 24 hours of evolution, gastrointestinal symptoms 4 (66.6%), abdominal pain, vomiting, diarrhea and nausea, neurological symptoms in 33%, (irritability, seizures and headache). Upon admission, 2 patients presented manifestations similar to Kawasaki, both under 5 years of age. An alteration in the leukocyte count was observed in 100%, lymphopenia in 5 (83%), thrombocytopenia in 3 (50%). 66% required management of intensive pediatric therapy, no patient with respiratory symptoms upon admission but with abnormalities in CT of thorax in 33% (2) of consolidation type during its evolution. RT-PCR was performed in 100%, reported as positive in 5 (83.4%), the determination of IgG and IgM antibodies in 2 patients was positive. Intravenous immunoglobulin and steroid was administered at 6 (100%), 2 (33%) received tocilizumab. Average hospital stay was 6 days, mortality of 50% was observed in the first 24 hours of admission. MIS-C is a new entity related to SARS-CoV-2. That affects previously healthy children, this should be suspected in a feverish child associated with gastrointestinal manifestations, this for early management, especially of multisystemic failure secondary to the large inflammatory process.


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