Differentiation of MIS-C Cases According to Disease Severity: Early Indicators and Clinical Approaches MIS-C Şiddetinin Ayırımı: Erken Belirteçler ve Klinik Yaklaşımlar

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Ay O., Güngör T. K., Turan C., Yurtseven A., Avcu G., Bal Z. Ş., ...Daha Fazla

Journal of Behcet Uz Children's Hospital, cilt.15, sa.3, ss.166-174, 2025 (ESCI, Scopus, TRDizin)

Özet

Objective: This study aims to identify key clinical and laboratory indicators that differentiate between severe and mild presentations of Multisystem Inflammatory Syndrome in Children (MIS-C), facilitating early recognition and application of targeted treatment strategies. Method: A retrospective, single-center analysis was conducted, reviewing clinical data of patients with MIS-C to identify factors associated with disease severity. The study assessed demographic, clinical, laboratory, and echocardiographic parameters, comparing patients with severe MIS-C (requiring inotropic support or prolonged intensive care unit stay) to those with mild MIS-C. Statistical analyses were performed to determine significant intergroup differences. Results: The group with severe MIS-C exhibited a longer duration of fever, presence of shock, tachycardia, and hypotension. Inflammatory markers such as lymphopenia, hypoalbuminemia, and elevated ferritin levels were significantly more pronounced in the severe MIS-C group. Elevated N-terminal pro-B-type natriuretic peptide and troponin levels were also significantly associated with severe MIS-C, indicating myocardial involvement. Echocardiographic findings of reduced ejection fraction and valve insufficiency were significant indicators of worsening clinical conditions. Coronavirus disease 2019 polymerase chain reaction and serological tests were not useful in differentiating between severe and mild forms of MIS-C. Conclusion: Early recognition of clinical features of MIS-C and classification based on disease severity can guide clinicians in diagnosis and treatment of MIS-C. Prolonged fever, shock, elevation of specific inflammatory, and cardiac markers, and echocardiographic abnormalities should raise suspicion for severe disease, prompting rapid intervention and tailored treatment strategies to improve patient outcomes and reduce potential mortality and longterm sequelae.