González-Restrepo DS, Cruz C, López-Medina E, Madrid AJ

Language: Spanish
References: 18
Page: 28-38
PDF size: 435.45 Kb.

ABSTRACT

Introduction: it is not easy to distinguish between multisystem inflammatory syndrome temporally associated with COVID-19 infection (MIS-C) and Kawasaki disease (KD) due to their clinical similarity, however, this exercise is important given that the management and prognosis will be different. Objective: to describe the cases and outcomes of MIS-C or EK in pediatric patients at the Hospital Universitario del Valle and Imbanaco Medical Center in Cali, Colombia between July 2020 and June 2022. Material and methods: multicenter prospective cohort study in patients with MIS-C and Kawasaki disease in whom sociodemographic, clinical, paraclinical and therapeutic variables and follow-up at one year were evaluated. Results: a total of 22 patients with MIS-C and 17 with EK were included in the analysis. Compared to EK patients, MIS-C patients had higher median age (p = 0.002), higher system involvement, especially gastrointestinal (p = 0.006) and pulmonary (p = 0.027), higher inflammatory biomarker levels, lower lymphocyte (p = 0.001) and platelet (p = 0.002) counts; At the cardiovascular level, there was a higher prevalence of systolic dysfunction, valvular insufficiency and myocarditis. In their clinical course, patients with MIS-C were more likely to be admitted to the Intensive Care Unit (ICU) and Neonatal Intensive Care Unit (NICU), present cardiogenic shock and require inotropic drugs. Patients with KD were characterized by greater cutaneous involvement (p = 0.000) and lymphadenopathy (p = 0.057). No patient died. At 1-year follow-up, all patients who underwent echocardiographic evaluation had a normal result in both groups. Conclusions: in comparison with KD, patients with MIS-C presented a higher median age, more system involvement, shock, thrombocytopenia, lymphopenia and higher levels of biomarkers. The prognosis of both pathologies is good, there were no deaths and the one-year follow-up of these patients showed complete resolution of cardiovascular alterations.

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