{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:35:10Z","timestamp":1787009710220,"version":"build-2736575974"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,4]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n To describe the clinico-laboratory profile, intensive care needs and outcome of multisystem inflammatory syndrome in children (MIS-C) during the first and second waves.<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n This retrospective study was conducted in the paediatric emergency and paediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India involving 122 children with MIS-C admitted during the first wave (September 2020\u2013January 2021, n\u2009=\u200940) and second wave (February 2021\u2013September 2021, n\u2009=\u200982) of coronavirus disease 2019 (COVID-19).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The median (interquartile range) age was 7 (4\u201310) years and 67% were boys. Common manifestations included fever (99%), abdominal symptoms (81%), rash (66%) and conjunctival injection (65%). Elevated C-reactive protein (97%), D-dimer (89%), procalcitonin (80%), IL-6 (78%), ferritin (56%), N-terminal pro B-type natriuretic peptide (84%) and positive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibody (81%) were common laboratory abnormalities. Cardiovascular manifestations included myocardial dysfunction (55%), shock (48%) and coronary artery changes (10%). The treatment included intensive care support (57%), non-invasive (33%) and invasive (18%) ventilation, vasoactive drugs (47%), intravenous immunoglobulin (IVIG) (83%), steroids (85%) and aspirin (87%). The mortality was 5% (n\u2009=\u20096). During the second wave, a significantly higher proportion had positive SARS-CoV-2 antibody, contact with COVID-19 and oral mucosal changes; lower markers of inflammation; lower proportion had lymphopenia, elevated IL-6 and ferritin; lower rates of shock, myocardial dysfunction and coronary artery changes; lesser need of PICU admission, fluid boluses, vasoactive drugs and IVIG; and shorter hospital stay.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n MIS-C is a febrile multisystemic disease characterized by hyperinflammation, cardiovascular involvement, temporal relationship to SARS-CoV-2 and good outcome with immunomodulation and intensive care. During the second wave, the severity of illness, degree of inflammation, intensive care needs, and requirement of immunomodulation were less as compared to the first wave.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/tropej\/fmac068","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T09:56:15Z","timestamp":1661334975000},"source":"Crossref","is-referenced-by-count":7,"title":["Clinico-Laboratory Profile, Intensive Care Needs and Short-Term Outcome of Multisystem Inflammatory Syndrome in Children (MIS-C): Experience during First and Second Waves from North India"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6370-8258","authenticated-orcid":false,"given":"Suresh Kumar","family":"Angurana","sequence":"first","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthi","family":"Nallasamy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj Rohit","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Naganur","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahendra","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kapil","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Virology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnab","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Virology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidharan","family":"Jayashree","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"2022090114401608700_fmac068-B1","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1001\/jama.2021.2091","article-title":"Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19","volume":"325","author":"Feldstein","year":"2021","journal-title":"JAMA"},{"key":"2022090114401608700_fmac068-B2","doi-asserted-by":"crossref","first-page":"fmab055","DOI":"10.1093\/tropej\/fmab055","article-title":"Intensive care needs and short-term outcome of multisystem inflammatory syndrome in children (MIS-C): experience from North India","volume":"67","author":"Angurana","year":"2021","journal-title":"J Trop 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