The “After Wave”: Pediatric multisystem inflammatory syndrome temporally associated with COVID-19 in a series of children from Eastern India

BACKGROUND: The objective of the study is to describe the presentation, treatment and outcomes of children with multisystem inflammatory syndrome with COVID-19 (MIS-C) in a tertiary care centre in Eastern India. METHODS: Retrospective data of children diagnosed with MIS-C during the SARS CoV-2 pandemic were obtained from hospital records. Clinical details, laboratory profile, treatment protocol and outcomes of children with MIS-C between 01 Nov 2020 and 30 June 2021 were analysed. RESULTS: Ten children (7 males) with a mean age of 6.8 years (median age 5.5 years, interquartile range 3.75-9.5) were analysed. COVID-19 RT-PCR was negative in all patients, whereas the IgG COVID antibody was positive in all children (100%). Seven children (7/10) had a history of contact with SARS CoV-2–positive adults. Five (5/10) children presented with cardiogenic shock. All children had evidence of a hyperinflammatory syndrome. Nine children (9/10) had predominant gastrointestinal and cardiovascular involvement. None had echocardiographic evidence of coronary dilatation or aneurysms either on admission or on follow-up. The elevated neutrophil lymphocyte ratio and D-dimer were found in all patients. All children responded to immunomodulatory treatment. None had residual deficit on discharge or at 4-week follow-up. There was no mortality. CONCLUSION: Children with MIS-C have good prognosis if early immunomodulatory treatment is instituted. Further prospective studies for long-term outcomes in children with MIS-C are required it being a novel entity recently described.