A hospital based comparative study of the first and second waves of Covid-19 related multi-system inflammatory syndrome in children

Introduction: Studies have shown the differential impact of the second surge of acute Covid-19 infection, across age, clinical outcome and ethnicity. How these factors impact the clinical characteristics and outcome of multisystem inflammatory syndrome in children (MIS-C) is largely unknown.

Objectives: This hospital based comparative study was undertaken to analyse the clinical characteristics and outcomes of patients admitted with MIS-C during the two waves of Covid-19 infection in a tertiary care teaching hospital in South India.

Method: Patients admitted between September 2020 and October 2021 with MIS-C were included in this study. Patient demographics, laboratory values and treatment details were compared between the two surges of COVID 19 related MIS-C. 

Results: Sixty-five children were admitted with MIS-C in the first wave and 73 in the second wave. More children were referred with a diagnosis of MIS-C in the second wave (p=0.001). There was no significant difference in the mean age or male-female ratio between the two waves. A significantly higher proportion of children in the second wave had cervical lymphadenitis (p=0.02). Need for intensive care unit (ICU) admission (p<0.001), shock (p<0.001), respiratory support (p<0.001) and multi-organ involvement (p<0.001) were significantly lower in the second wave. 

Conclusions: A significantly higher proportion of children with MIS-C in the second wave of Covid-19 infection had cervical lymphadenitis. The need for ICU admission, shock, respiratory support and multi-organ involvement were significantly lower in children with MIS-C in the second wave of Covid-19 infection.

Sri Lanka Journal of Child Health, 2022; 51(3): 431-435