{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:41:45Z","timestamp":1787067705218,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 varies widely in its presentation and severity, with low mortality in high-income countries. In this study in 16 Latin American countries, we sought to characterize patients with MIS-C in the pediatric intensive care unit (PICU) compared with those hospitalized on the general wards and analyze the factors associated with severity, outcomes, and treatment received.\n                    <jats:bold>Study Design:<\/jats:bold>\n                    An observational ambispective cohort study was conducted including children 1 month to 18 years old in 84 hospitals from the REKAMLATINA network from January 2020 to June 2022.\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 1239 children with MIS-C were included. The median age was 6.5 years (IQR 2.5-10.1). Eighty-four percent (1043\/1239) were previously healthy. Forty-eight percent (590\/1239) were admitted to the PICU. These patients had more myocardial dysfunction (20% vs 4%;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.01) with no difference in the frequency of coronary abnormalities (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.77) when compared to general ward subjects. Of the children in the PICU, 83.4% (494\/589) required vasoactive drugs, and 43.4% (256\/589) invasive mechanical ventilation, due to respiratory failure and pneumonia (57% vs 32%;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.01). On multivariate analysis, the factors associated with the need for PICU transfer were age over 6 years (aOR 1.76 95% CI 1.25-2.49), shock (aOR 7.06 95% CI 5.14-9.80), seizures (aOR 2.44 95% CI 1.14-5.36), thrombocytopenia (aOR 2.43 95% CI 1.77-3.34), elevated C-reactive protein (aOR 1.89 95% CI 1.29-2.79), and chest x-ray abnormalities (aOR 2.29 95% CI 1.67-3.13). The overall mortality was 4.8%.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Children with MIS-C who have the highest risk of being admitted to a PICU in Latin American countries are those over age six, with shock, seizures, a more robust inflammatory response, and chest x-ray abnormalities. The mortality rate is five times greater when compared with high-income countries, despite a high proportion of patients receiving adequate treatment.\n                  <\/jats:p>","DOI":"10.1177\/08850666241233189","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T03:39:42Z","timestamp":1709091582000},"page":"785-793","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk Factors Associated with Intensive Care Admission in Children with Severe Acute Respiratory Syndrome Coronavirus 2-Related Multisystem Inflammatory Syndrome (MIS-C) in Latin America: A Multicenter Observational Study of the REKAMLATINA Network"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2874-2949","authenticated-orcid":false,"given":"Jaime","family":"Fern\u00e1ndez-Sarmiento","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Intensive 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