Clinical and laboratory-instrumental characteristic of multisystem inflammatory syndrome in children

Abstract

Purpose - to improve diagnostics and making multisystem inflammatory syndrome diagnosis in children based on the study of the clinical course and determination of laboratory and instrumental features.

Materials and methods. 15 cases of multisystem inflammatory syndrome in children who were hospitalized in the Infectious Diseases Boxed Department No.1 of the Vinnytsya Regional Children’s Clinical Hospital in 2021 were analyzed.

Results. The most common symptom was fever. Gastrointestinal disorders (53.33%), neurocognitive and vegetative symptoms (86.67%) were also found in children. Arthralgias, myalgias and pains in the lower extremities were in 33.33% of children, respiratory symptoms - in 20.00% of ones. Almost half of the children had skin rashes at physical examination. Scleritis and conjunctivitis was also noted in the quarter children. Leukocytosis was detected in 8 children (53.33%) in the results of blood count. Majority of children had elevated erythrocyte sedimentation rate, C-reactive protein and fibrinogen. D-dimer was increased in all children. 46.67% of children, according to chest ultrasound had fluid in the pleural cavity up to 7-10 mm, signs of interstitial pulmonary edema, increased echo-signals along the axillary line and the consolidation zone in the middle right lung from 3 mm to 6 mm. 60.0% of children had enlarged liver, spleen, fluid in the abdomen and enlarged multiple mesenteric lymph nodes according abdominal ultrasound.

Conclusions. The diagnosis of multisystem inflammatory syndrome should be made according to the main criteria. It requires differential diagnosis with a number of infectious and systemic diseases. Prolonged fever and neurocognitive symptoms were the most common symptoms in hospitalized patients. Gastrointestinal and cardiovascular disorders, skin rashes prevailed. Typical laboratory changes were elevated markers of inflammation, evidence of coagulopathy and markers of previous coronavirus infection. Significant features among echosonographic changes were enlargement of parenchymal organs and signs of effusion in the cavities. Child protection from the impact of coronavirus infection should be improved.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.