Campbell J, et al. Abstract 82. Presented at: IDWeek; Oct. 21-25, 2020 (virtual meeting).
Study highlights overlapping symptoms of MIS-C, other illnesses
A study presented at IDWeek underscored the need to identify clinical and laboratory features that distinguish multisystem inflammatory syndrome in children from other similar illnesses, researchers said.
Multisystem inflammatory syndrome in children (MIS-C) is a newly reported condition that has been associated with COVID-19.
In a study that included 39 children aged between 2 and 12 years who were being evaluated for MIS-C, Jeffrey Campbell, MD, a clinical pediatric infectious diseases fellow at Boston Children’s Hospital, and colleagues reported that 19 were diagnosed with MIS-C per the Massachusetts Department of Public Health’s case definition, which includes symptoms that overlap with other childhood infections, including fever and elevated inflammatory markers.
“While most MIS-C case definitions require clinicians to exclude ‘plausible’ alternative infectious diagnoses, these definitions aren’t uniformly clear about what constitutes a ‘plausible’ alternative diagnosis,” Campbell told Healio.
Seven of the 39 patients received a diagnosis of a non-SARS-CoV-2 infection. Of those seven, five had bacterial infections, one had a viral infection and the other a viral and bacterial coinfection.
Two of the patients diagnosed with MIS-C also had a non-SARS-CoV-2 infection.
“We don’t yet know why some patients develop MIS-C, nor do we know how it affects their immune systems or susceptibility to infections. Hopefully, additional research will shed light on these questions,” Campbell said.
Five of the 19 patients who were diagnosed with MIS-C (26%) received a positive PCR test for SARS-CoV-2 infection. Of these five patients, four were treated with remdesivir.
Of the 39 patients being evaluated for MIS-C, 17 (44%) received IV immune globulin, 14 (36%) received aspirin, four (10%) anakinra and 14 (36%) methylprednisolone. More than half of the patients (n = 21; 54%) received antibacterial therapy and five (13%) received antiviral therapies.
“Clinicians should be aware that symptoms and findings of MIS-C can overlap with symptoms and findings of non-SARS-CoV-2 infections,” Campbell said. “Clinicians should maintain a broad differential diagnosis when evaluating patients with features of MIS-C since non-SARS-CoV-2 infections may either explain these features or occur at the same time as MIS-C.”