Distinct phenotypes of multisystem inflammatory syndrome in children: a cohort study
Authors' conclusion
MIS-C patients in a later stage of the pandemic displayed a more severe phenotype, reflecting the impact of distinct SARS-CoV-2 variants. NT-proBNP emerged as the most crucial feature associated with intensive care need
Study context
- Population
- Youth aged 0–18 years fulfilling the WHO case definition of multisystem inflammatory syndrome in children (MIS-C), admitted to the Alberta Children's Hospital, May 2020-December 2021median age 6 years
- Participants
- 57 participants
- Exposure
- MIS-C in phase 2 vs phase 1 of the COVID-19 pandemic
- Outcome
- Peak ferritin (µg/l)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
P = 0.001
Observational data: associations, not effects.
Further findings
Peak NT-proBNP (ng/l)
P = 0.02
Peak D-dimer (mg/l)
P = 0.004
Liver enzyme abnormalities
P = 0.02
Hypoalbuminemia
P = 0.03
Thrombocytopenia
P = 0.007
Need of non-invasive/mechanical ventilation
P = 0.03
Intensive care required (whole cohort)
- Patients requiring intensive care
- 30 (53%)
Unsupervised clustering classification
- Classified in the correct wave
- 47%
- Classified in the correct phase
- 74%
Features associated with need for intensive care
- NT-proBNP was the only significant contributor in all applied multivariate regression models
Peak CRP and ferritin by treatment with biologic agents (treated vs not treated)
- Peak CRP (mg/l), median (IQR), treated vs not
- 240.9 (132.9-319.4) vs. 155.8 (101.0-200.7), P = 0.02
- Peak ferritin (µg/l), median (IQR), treated vs not
- 1380 (509-1753) vs. 473 (280-296)
- Significantly associated with biologic treatment
Original publication
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