Six Month Outcomes In Children After Multisystem Inflammatory Syndrome (Mis- C) Associated With Covid-19

Backgrounds: Multisystem inflammatory syndrome in children (MIS-C) is a rare but dangerous complication of COVID-19. The pathophysiology, immunology and long-term clinical outcomes are not yet fully known, and further research is required. The aim of our study is to identify and understand long-term outcomes of MIS-C.

Methods: In this prospective cohort study conducted from January 2021 to December 2021, 30 patients with MIS-C were enrolled. To identify the outcomes, all patients were evaluated in face-to-face visits 2 weeks, 8 weeks, and 6 months after diagnosis using clinical assessment, laboratory testing and cardiological examination.

Results: During the two-week follow up visit 20% (n=6) of children had abnormal clinical findings. Notably, significant increase was seen in these findings at 8-week follow-up (63,3%, n=14). Most often reported symptoms at 8-weeks were cognitive, musculoskeletal and neurological sequelae. At 6-month follow-up only 30% (n=9) of patients had any abnormal clinical findings. During the 2-week visit, 90% (n=27) of patients had abnormal complete blood cell and platelet counts, but 60% (n=18) of children had abnormal inflammatory parameters (D-dimers, ferritin, CRP, Il-6). Significant improvement of hematologic and inflammatory parameters was seen at 8-week (6.7%, n=2) and 6-month (3.3%, n=1) follow-up. In addition, at 2-week follow-up 60% (n=18) of patients had abnormal electrocardiograms, but 13,3% (n=4) patients had abnormal echocardiography, including two patients with diagnosed coronary artery involvement. At 8 week and 6-month follow-up visits all patients had normal cardiological findings.

Conclusions/Learning Points: Abnormal clinical, laboratory and cardiological findings were seen in majority of patients two weeks after MIS-C with significant improvement in following weeks