Resumo

MAMMEN, V et al. Clinical, laboratory and echocardiographic parameters suggestive of multi-system inflammatory syndrome in children at a tertiary hospital in South Africa. S. Afr. j. child health [online]. 2025, vol.19, n.1, pp.8-14. ISSN 1999-7671.  https://doi.org/10.7196/SAJCH.2025.v19i1.1759.

BACKGROUND: Worldwide studies have described features and outcomes of multi-system inflammatory syndrome in children (MIS-C) to assist with the diagnosis and guide medical management, with few studies emanating from Africa OBJECTIVE: To describe the clinical, laboratory and echocardiographic parameters suggestive of MlS-C METHODS: The paediatric cardiology database identified all patients referred with suspected MlS-C at Chris Hani Baragwanath Academic Hospital (CHBAH), from 1 March 2020 until 31 December 2021. Patients were classified as 'MlS-C likely' or 'MlS-C unlikely' based on the 2020 Centers for Disease Control and Prevention (CDC) criteria for MlS-C RESULTS: A total of 101 patients were analysed, with 60 in the 'MlS-C likely' group and 41 patients in the 'MlS-C unlikely' group. The significant clinical features differentiating between the 'MlS-C likely' and the 'MlS-C unlikely' groups were the presence of documented fever (p=0.018) and eye changes (p<0.001). Patients with a positive COVlD antibody test that were referred for suspected MlS-C were most likely to present with MlS-C (p< 0.001). Laboratory parameters suggesting a greater likelihood of patients having MlS-C was a high troponin T (p=0.018) and a high C-reactive protein (CRP) (p=0.019). The main echocardiographic feature associated with a MlS-C diagnosis was left ventricular (LV) dysfunction at presentation (p=0.023). ln the adjusted logistic regression analyses, the contributory findings associated with a greater risk of having MlS-C were fever and LV dysfunction (OR 6.52 (95% Cl 2.31 - 18.45); p<0.001 and 6.70 (95% confidence interval (Cl) 1.61 - 28.59); p =0.009, respectively CONCLUSION: Clinical features such as documented fever and eye changes together with a positive COVlD antibody test suggest that patients had MlS-C in our setting. Laboratory findings of elevated CRP and troponin T in patients with suspected MlS-C assisted with the diagnosis. Patients with suspected MlS-C with LV dysfunction at presentation were more likely to have MlS-C

Palavras-chave : COVlD-19; multi-system inflammatory syndrome in children; MlS-C; echocardiography in MlS-C.

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