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Clinical Phenotype and Outcomes of Multisystem Inflammatory Syndrome in Children According to SARS‐CoV‐2 Laboratory Status During 2020–2021: A Retrospective Observational Study

Year: 2026

Type: article

Abstract: ABSTRACT Background and Aims Multisystem inflammatory syndrome in children (MIS‐C) is a post‐infectious inflammatory condition associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) that can affect multiple organ systems. Data comparing clinical features and outcomes between MIS‐C patients with and without laboratory evidence of coronavirus disease 2019 (COVID‐19) remain limited. Methods This retrospective observational study was conducted at Mofid Children's Hospital, a pediatric referral center in Tehran, Iran, between March 2020 and July 2021. Children diagnosed with MIS‐C based on World Health Organization (WHO) criteria were included and classified into groups with and without laboratory evidence of SARS‐CoV‐2 infection according to PCR and/or IgG serology results. Demographic data, clinical manifestations, laboratory and imaging findings, treatments, and outcomes were compared between the groups using univariate and multivariable analyses. A p ‐value < 0.05 was considered statistically significant. Results A total of 121 patients with MIS‐C were included, of whom 44 (36.4%) had laboratory evidence of SARS‐CoV‐2 infection. The mean age was 4.74 ± 3.99 years, and 61.2% were male. ICU admission occurred in 21.5% and mortality was 2.5%. In univariate analysis, fever during the first 24 h of hospitalization and antiviral use were more frequent in the group with laboratory evidence, whereas conjunctivitis and elevated C‐reactive protein levels were more common among the group without laboratory evidence; however, CRP did not differ significantly between groups when analyzed as a continuous variable. In multivariable analysis, fever during the first 24 h of hospitalization was the only variable associated with laboratory evidence of SARS‐CoV‐2 infection (aOR 2.57; 95% CI 1.05–6.30; p = 0.040). Conclusion MIS‐C presents with broad and largely overlapping clinical, laboratory, and imaging features regardless of SARS‐CoV‐2 laboratory status, and the few observed differences were exploratory and of limited discriminative value. These findings highlight the importance of considering MIS‐C even in the absence of laboratory confirmation of SARS‐CoV‐2 infection.

Source: Health Science Reports

DOI: 10.1002/hsr2.73483