The Impact of Multisystem Inflammatory Syndrome in Children Associated with COVID-19

Barden, Alaa A.; Fahmy, Eman M.; Ahmed, Heba A.; El-kannishy, Sherif M. H.; Aboulfotuh, Sahar; Mahmoud, Noha M.; Essa, Sara G.

doi:10.21608/ejmm.2025.372442.1546

The Impact of Multisystem Inflammatory Syndrome in Children Associated with COVID-19

Document Type : New and original researches in the field of Microbiology.

Authors

¹ Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

² Department of Paediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt

³ Department of Clinical and Chemical Pathology, Faculty of Medicine, Sohag University, Sohag, Egypt

⁴ Department of Toxicology, Mansoura Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt

⁵ Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

10.21608/ejmm.2025.372442.1546

Abstract

Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious post-infectious complication associated with SARS-CoV-2 infection. Hyperinflammation and multi-organ dysfunction are hallmarks of MIS-C. MIS-C poses diagnostic and therapeutic challenges. Objective: The study intended to assess clinical and laboratory manifestations and severity predictors among MIS-C patients. Methodology: This retrospective study analysed data from 68 paediatric patients attained the paediatric intensive care unit (PICU) at Sohag University Hospital between September 2020 and August 2021. Based on laboratory confirmation of SARS-CoV-2 infection and WHO criteria, patients were allocated to the MIS-C group. Demographic and clinical data were collected, and laboratory parameters were compared between groups. Results: Of the 68 patients, 29 (42.6%) encountered the criteria for MIS-C. MIS-C cases were significantly older (median 9.4 vs. 3.4 years,) and heavier (median 36 vs. 15.5) than non-MIS-C patients. Fever, gastrointestinal symptoms (diarrhoea, vomiting, abdominal pain), and concurrent cardiac and renal dysfunction were predominant features in the MIS-C group. Laboratory analysis revealed significant elevations in inflammatory markers (CRP, ferritin, ESR), coagulation abnormalities (D-dimer, INR), and liver enzymes (ALT, AST) in MIS-C patients. Notably, TNF-α and IL-6 values did not considerably differ between the groups. Conclusions: This investigation emphasizes the multisystemic nature of MIS-C and highpoints the necessity of early recognition and proactive care. The lack of significant elevation in TNF-α and IL-6 suggests that alternative inflammatory pathways may be involved in MIS-C pathogenesis in this population.

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