COMPARATIVE ANALYSIS OF CLINICAL AND LABORATORY DATA IN CHILDREN WITH MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH SARS-COV-2 IN THE REPUBLIC OF KAZAKHSTAN MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH SARS-COV-2
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Keywords
Keywords: paediatrics, MIS-C, SARS-CoV-2, Delta variant
Abstract
Background and Objectives: Data with more severe mutations of the SARS-CoV-2 virus, compared with the original wild-type strain of COVID-19 disease, were reported worldwide. The study aims to describe the clinical and laboratory manifestations of a multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 in the Republic of Kazakhstan and to compare the severity of the disease depending on the time of the circulating variant of SARS-CoV-2 virus.
Material and methods: A retrospective, multicentre, nationwide study of 89 children with MIS-C who received inpatient treatment from August 1, 2020, to December 1, 2021. The patients were allocated into two groups: 1(2020) - 45 children and 2 (2021) - 44 children. Study periods were characterized by the circulation of different strains of the SARS-CoV-2 virus.
Results: In children with MIS-C in 2021, acute renal failure, disseminated intravascular coagulation syndrome, and shock were statistically more frequently found, which led to fairly common admittance to the intensive care unit. When comparing laboratory data, the children with MIS-C in 2021 had higher values of inflammation markers: ferritin, procalcitonin, erythrocyte sedimentation rate, leukocytes, and neutrophils. Furthermore, these children had a lower level of lymphocytes than children with MIS-C in 2020.
Conclusions: MIS-C is a severe, life-threatening systemic disease characterized by multiple organ damage and important inflammatory changes in laboratory parameters. A more aggressive clinical course of MIS-C in 2021 may be associated with the emergence of new SARS-CoV-2 strains.
Keywords: children, MIS-C, variants of SARS-CoV-2
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References
1. Swann O V, Holden K A, Turtle L, Pollock L, Fairfield CJ, Drake TM et al. Clinical characteristics of children and young people admitted to hospital with COVID-19 in United Kingdom: prospective multicentre observational cohort study. BMJ 2020; 370: m3249. doi: https://doi.org/10.1136/bmj.m3249
2. Tian D, Sun Y, Zhou J, Ye Q. The Global Epidemic of the SARS-CoV-2 Delta Variant, Key Spike Mutations and Immune Escape. Front Immunol 2021; 12: 751-778. doi: 10.3389/fimmu.2021.751778
3. European Centre for Disease Prevention and Control. Threat Assessment Brief: Emergence of SARS-CoV-2 B.1.617 variants in India and situation in the EU/EEA. Stockholm: ECDC; 2021. Available online: https://www.ecdc.europa.eu/en/publications-data/threat-assessment-emergence-SARS-CoV-2-b1617-variants. Accessed on August 19, 2021.
4. Sheikh A, McMenamin J, Taylor B, Robertson C; Public Health Scotland and the EAVE II Collaborators. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. Lancet 2021; 397(10293): 2461-2462. doi: 10.1016/S0140-6736(21)01358-1
5. Twohig, K.A., Nyberg, T., Zaidi, A., Simon Thelwall,, Mary Sinnathamby, Shirin Aliabadi,et al. Hospital Admission and Emergency Care Attendance Risk for SARS-CoV-2 Delta (B.1.617.2) Compared with Alpha (B.1.1.7) Variants of Concern: A Cohort Study. Lancet Infect. Dis. 2021; 22: 35–42. DOI:https://doi.org/10.1016/S1473-3099(21)00475-8
6. Fisman DN, Tuite AR. Evaluation of the relative virulence of novel SARS-CoV-2 variants: a retrospective cohort study in Ontario, Canada. CMAJ. 2021; 193(42): E1619-E1625. DOI: 10.1503/cmaj.211248
7. Siegel DA, Reses HE, Cool AJ, Craig N Shapiro, Joy Hsu, Tegan K Boehmer,et al. Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0–17 Years — United States, August 2020–August 2021. MMWR Morb Mortal Wkly Rep 2021; 70 (11): 1249–1254. DOI: 10.15585/mmwr.mm7036e1
8. Molteni, E., Sudre, C. H., Canas, L. S., Bhopal S., Hughes R., Chen L et al. Illness characteristics of COVID-19 in children infected with the SARS-CoV-2 Delta variant. MedRxiv 2021.10.06.21264467. doi: https://doi.org/10.1101/2021.10.06.21264467
9. The Ministry of Health of the Republic of Kazakhstan. The Ministry of Health of the Republic of Kazakhstan continues to identify the circulation of strains (2021). https://www.gov.kz/memleket/entities/dsm/press/news/details/258353?lang=ru
10. Centers for Disease Control and Prevention (2020) Emergency preparedness and response: health alert network. https://emergency.cdc.gov/han/2020/han00432.asp. Accessed Nov 10 2020.
11. World Health Organization. Multisystem inflammatory syndrome in children and adolescents with COVID-19 (2020) www.who.int/publications-detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-COVID-19. Accessed November 10, 2020.
12. Boranbaeva R.Z., Umesheva K.A., Salieva. S.S., Baesheva D.A., Abdrakhmanova S.T. Coronavirus infection COVID-19 in children. Clinical Protocol for Diagnosis and Treatment - MH RK -2020 - p. 6-23.
https://diseases.medelement.com/disease/%D0%BA%D0%BE%D1%80%D0%BE%D0%BD%D0%B0%D0%B2%D0%B8%D1%80%D1%83%D1%81%D0%BD%D0%B0%D1%8F-%D0%B8%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D1%8F-COVID-19-%D1%83-%D0%B4%D0%B5%D1%82%D0%B5%D0%B9-2020/16499
13. Yasuhara J, Watanabe K, Takagi H, Sumitomo N, Kuno T. COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis. Pediatric Pulmonology. 2021; 56:837- 848. doi: 10.1002/ppul.25245
14. Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, Drake TM, et al. Clinical characteristics of children and young people admitted to hospital with COVID-19 in United Kingdom: prospective multicentre observational cohort study BMJ 2020;370:m3249. doi: 10.1136/bmj.m3249.
15. Pawar R., Gavade V, Patil, N, Mali V., Girwalkar A, Tarkasband V, et al. Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series. Children 2021 ;8(7): 572. doi: 10.3390/children8070572
16. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF., et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020; 383(4): 334-346. doi: 10.1056/NEJMoa2021680.
17. Kostik MM, Bregel LV, Avrusin IS, Dondurei EA, Matyunova AE, Efremova OS, et al. Distinguishing Between Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children and the Kawasaki Disease: Development of Preliminary Criteria Based on the Data of the Retrospective Multicenter Cohort Study. Front Pediatr 2021; 9: 787353. doi: 10.3389/fped.2021.787353.
18. Ozsurekci Y, Gürlevik S, Kesici S, Akca UK, Oygar PD, Aykac K, et al. Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean. Clin Rheumatol. 2021 Aug;40(8):3227-3237. doi: 10.1007/s10067-021-05631-9.
19. Yasuhara J, Watanabe K, Takagi H, Sumitomo N, Kuno T. COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis. Pediatr Pulmonol. 2021;56(5): 837-848. DOI: 10.1002/ppul.25245
20. Abrams JY, Oster ME, Godfred-Cato SE, Bryant B, Datta SD, Campbell AP, et al. Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study. Lancet Child Adolesc Health. 2021 May;5(5):323-331. doi: 10.1016/S2352-4642(21)00050-X.
21. Ahmed M, Advani S, Moreira A, Zoretic S, Martinez J, Chorath K, et al. Multisystem inflammatory syndrome in children: A systematic review. EClinicalMedicine. 2020; 26: 100527.
22. Zhao Y, Yin L, Patel J, Tang L, Huang Y. The inflammatory markers of multisystem inflammatory syndrome in children (MIS-C) and adolescents associated with COVID-19: A meta-analysis. J Med Virol. 2021; 93(7): 4358-4369. doi: 10.1016/j.eclinm.2020.100527.
23. Zhang QY, Xu BW, Du JB. Similarities and differences between multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease: clinical presentations, diagnosis, and treatment. World J Pediatr. 2021; 17(4): 335-340. doi: 10.1007/s12519-021-00435-y.
24. Webb BJ, Peltan ID, Jensen P, Hoda D, Hunter B, Silver A., et al. Clinical criteria for COVID-19-associated hyperinflammatory syndrome: a cohort study. Lancet Rheumatol. 2020; 2(12): e754-e763
25. Allison D Miller, Laura D Zambrano, Anna R Yousaf, Joseph Y Abrams, Lu Meng, Michael J Wu, et al. Multisystem Inflammatory Syndrome in Children—United States, February 2020–July 2021, Clinical Infectious Diseases, 2021;, ciab1007, https://doi.org/10.1093/cid/ciab1007
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