Clinical Characteristics, Laboratory Features, and Outcomes of 151 Pediatric Patients with COVID-19 and MIS-C: A Single-center Study in the Northwest of Iran

Abstract
Background: To date, multiple outbreaks of coronavirus disease 2019 (COVID-19) have been reported. Moreover, a wide spectrum of multiple organ involvements has been reported. Objectives: This study aimed to describe and compare the clinical characteristics, laboratory features, and outcomes of pediatric patients with COVID-19 and Multisystem Inflammatory Syndrome of Children (MIS-C). Methods: This cohort retrospective study was performed on patients under 18 years admitted with a diagnosis of COVID-19 and MIS-C in a pediatric referral center in the northwest of Iran from March 2020 to June 2021. This study included the data obtained from three time points, including on admission, 1 week, and 3 months after admission. Results: In this study, 151 patients with a mean age of 5.3 ± 4.1 years were enrolled, out of whom 51.7% and 48.3% were in COVID-19 and MIS-C groups, respectively. Fever was observed in 64.9% of the patients. In the third-month follow-up, there was no abnormality in the neurologic, respiratory, or gastrointestinal systems. For most patients with cardiovascular involvement, normal ventricular and valvar function, and coronary arteries were obtained in follow-up. Approximately one-third of the subjects were admitted to the pediatric intensive care unit (PICU). Neonates, those with cardiac involvement and underlying disease, were at a higher risk for PICU admission (P < 0.001). Moreover, six patients died. Conclusions: Although irreversible post-COVID-19 organ involvement is uncommon among pediatric patients, routine and preplanned follow-up programs play an important role in achieving satisfactory outcomes.
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