High Fatality Rates in Pediatric Multisystem Inflammatory Syndrome: A Multicenter Experience From the Epicenter of Brazil's Coronavirus Pandemic

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorALMEIDA, Flavia Jacqueline
dc.contributor.authorJAROVSKY, Daniel
dc.contributor.authorFARIAS, Camila Giuliana Almeida
dc.contributor.authorCASTILHO, Taisa Roberta Ramos Nantes de
dc.contributor.authorCAETANO, Thiago Gara
dc.contributor.authorBORSETTO, Cibele Cristina Manzoni Ribeiro
dc.contributor.authorAGUIAR, Andressa Simoes
dc.contributor.authorARAUJO, Carolina Serafini de
dc.contributor.authorPEREIRA, Maria Fernanda Badue
dc.contributor.authorMARQUES, Heloisa Helena de Sousa
dc.contributor.authorSILVA, Clovis Artur
dc.contributor.authorTANNURE, Andressa Ribeiro de Matos
dc.contributor.authorPRADO, Rogerio
dc.contributor.authorMAU, Luciana Becker
dc.contributor.authorALVARES, Paula Andrade
dc.contributor.authorSIQUEIRA, Antonio Carlos de
dc.contributor.authorSCREMIN, Gustavo Paro
dc.contributor.authorOTSUKA, Marcelo
dc.contributor.authorARNONI, Mariana Volpe
dc.contributor.authorLAPORTE, Roberta Machado Rissoni
dc.contributor.authorCARLESSE, Fabianne Altruda de Moraes Costa
dc.contributor.authorEJZENBERG, Fernanda
dc.contributor.authorBEREZIN, Eitan Naaman
dc.contributor.authorSAFADI, Marco Aurelio Palazzi
dc.date.accessioned2024-04-05T19:33:58Z
dc.date.available2024-04-05T19:33:58Z
dc.date.issued2024
dc.description.abstractBackground:Brazil ' s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children.We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of Sao Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables.A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants.We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.Background:Brazil ' s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children.We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of Sao Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables.A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants.We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.Background:Brazil ' s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children.We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of Sao Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables.A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants.We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.Background:Brazil ' s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children.We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of Sao Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables.A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants. We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
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dc.description.indexDimensions
dc.description.indexWoS
dc.identifier.citationPEDIATRIC INFECTIOUS DISEASE JOURNAL, v.43, n.2, p.109-116, 2024
dc.identifier.doi10.1097/INF.0000000000004164
dc.identifier.eissn1532-0987
dc.identifier.issn0891-3668
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58947
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINSeng
dc.relation.ispartofPediatric Infectious Disease Journal
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINSeng
dc.subjectSARS-CoV-2eng
dc.subjectCOVID-19eng
dc.subjectMIS-Ceng
dc.subjecthospital-based surveillanceeng
dc.subjectPediatriceng
dc.subjectBrazileng
dc.subject.otherchildren mis-ceng
dc.subject.otherkawasaki-diseaseeng
dc.subject.wosImmunologyeng
dc.subject.wosInfectious Diseaseseng
dc.subject.wosPediatricseng
dc.titleHigh Fatality Rates in Pediatric Multisystem Inflammatory Syndrome: A Multicenter Experience From the Epicenter of Brazil's Coronavirus Pandemiceng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalALMEIDA, Flavia Jacqueline:Santa Casa Sao Paulo, Dept Pediat, Sao Paulo, Brazil; Santa Casa Sao Paulo Sch Med Sci, Dept Pediat, Sao Paulo, Brazil; Hosp Infantil Sabara, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalJAROVSKY, Daniel:Santa Casa Sao Paulo, Dept Pediat, Sao Paulo, Brazil; Santa Casa Sao Paulo Sch Med Sci, Dept Pediat, Sao Paulo, Brazil; Hosp Infantil Sabara, Dept Pediat, Sao Paulo, Brazil; Santa Casa Sao Paulo, Dept Pediat, Alameda Jau 585-121, BR-01420001 Sao Paulo, SP, Brazil
hcfmusp.author.externalFARIAS, Camila Giuliana Almeida:Hosp Infantil Sabara, Dept Pediat, Sao Paulo, Brazil; Hosp & Maternidade Sao Luiz Analia Franco, Dept Pediat, Sao Paulo, Brazil; Hosp & Maternidade Sao Luiz Sao Caetano, Dept Pediat, Sao Caetano do Sul, Brazil
hcfmusp.author.externalCASTILHO, Taisa Roberta Ramos Nantes de:Hosp & Maternidade Sao Luiz Analia Franco, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalCAETANO, Thiago Gara:Hosp & Maternidade Sao Luiz Sao Caetano, Dept Pediat, Sao Caetano do Sul, Brazil
hcfmusp.author.externalBORSETTO, Cibele Cristina Manzoni Ribeiro:Hosp & Maternidade Sao Luiz Sao Caetano, Dept Pediat, Sao Caetano do Sul, Brazil
hcfmusp.author.externalAGUIAR, Andressa Simoes:Hosp Sao Luiz Gonzaga, Dept Pediat, Sao Paulo, Brazil; Hosp Infantil Candido Fontoura, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalARAUJO, Carolina Serafini de:Hosp Geral Itapevi, Dept Pediat, Itapevi, Brazil
hcfmusp.author.externalTANNURE, Andressa Ribeiro de Matos:Hosp Municipal Tatuape Dr Carmino Caricchio, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalPRADO, Rogerio:Hosp Municipal Tatuape Dr Carmino Caricchio, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalMAU, Luciana Becker:Hosp Municipal Infantil Menino Jesus, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalALVARES, Paula Andrade:Hosp Municipal Crianca & Adolescente Guarulhos, Dept Pediat, Guarulhos, Brazil
hcfmusp.author.externalSIQUEIRA, Antonio Carlos de:Hosp Reg Sul, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalSCREMIN, Gustavo Paro:Hosp Reg Sul, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalOTSUKA, Marcelo:Hosp Infantil Darcy Vargas, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalARNONI, Mariana Volpe:Hosp Infantil Darcy Vargas, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalLAPORTE, Roberta Machado Rissoni:Hosp Municipal Mogi Das Cruzes, Dept Pediat, Mogi Das Cruzes, Brazil
hcfmusp.author.externalCARLESSE, Fabianne Altruda de Moraes Costa:Univ Fed Sao Paulo, Inst Oncol Pediat, Dept Pediat, GRAACC, Sao Paulo, Brazil
hcfmusp.author.externalEJZENBERG, Fernanda:Hosp Municipal Boi Mirim Dr Moyses Deutsch, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalBEREZIN, Eitan Naaman:Santa Casa Sao Paulo, Dept Pediat, Sao Paulo, Brazil; Santa Casa Sao Paulo Sch Med Sci, Dept Pediat, Sao Paulo, Brazil
hcfmusp.author.externalSAFADI, Marco Aurelio Palazzi:Santa Casa Sao Paulo Sch Med Sci, Dept Pediat, Sao Paulo, Brazil; Hosp Infantil Sabara, Dept Pediat, Sao Paulo, Brazil; Hosp Infantil Candido Fontoura, Dept Pediat, Sao Paulo, Brazil
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcMARIA FERNANDA BADUE PEREIRA
hcfmusp.contributor.author-fmusphcHELOISA HELENA DE SOUSA MARQUES
hcfmusp.contributor.author-fmusphcCLOVIS ARTUR ALMEIDA DA SILVA
hcfmusp.description.beginpage109
hcfmusp.description.endpage116
hcfmusp.description.issue2
hcfmusp.description.volume43
hcfmusp.origemWOS
hcfmusp.origem.dimensionspub.1166229100
hcfmusp.origem.pubmed37991363
hcfmusp.origem.scopus2-s2.0-85183465134
hcfmusp.origem.wosWOS:001145838900021
hcfmusp.publisher.cityPHILADELPHIAeng
hcfmusp.publisher.countryUSAeng
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Artigos e Materiais de Revistas Científicas - COVID-19