{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:38:15Z","timestamp":1781325495097,"version":"3.54.1"},"reference-count":50,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a life-threatening condition that often requires intensive care unit (ICU) admission. The aim of this study was to determine risk factors for severe\/life-threatening course of MIS-C. The study included 166 patients (99 boys, 67 girls) aged 4 months\u201317 years (median 8.2 years). The criterion of severity was the fact of ICU admission. To conduct a comparative analysis, MIS-C patients were divided into two groups: patients hospitalized in the ICU (n = 84, 50.6%) and those who did not need ICU admission (n = 82, 49.4%). Patients with a more severe course of MIS-C were significantly older. They had a higher frequency of signs such as rash, swelling, hepatomegaly, splenomegaly, and neurological and respiratory symptoms. Hypotension\/shock and myocardial involvement were much more common in patients with severe MIS-C. These patients had a more significant increase in CRP, creatinine, troponin, and D-dimer levels. Additionally, the presence of macrophage activation syndrome was higher in patients admitted to the ICU. Conclusion: Nineteen predictors of severe course of MIS-C were found, out of which hepatomegaly, splenomegaly, D-dimer &gt; 2568 ng\/mL, troponin &gt; 10 pg\/mL were mainly associated with the probability of being classified as early predictors of severe MIS-C requiring ICU admission.<\/jats:p>","DOI":"10.3390\/children10081366","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T10:08:59Z","timestamp":1691575739000},"page":"1366","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Determination of Risk Factors for Severe Life-Threatening Course of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4919-0939","authenticated-orcid":false,"given":"Ilia S.","family":"Avrusin","sequence":"first","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0546-1028","authenticated-orcid":false,"given":"Natalia N.","family":"Abramova","sequence":"additional","affiliation":[{"name":"Intensive Care Unite Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-1638","authenticated-orcid":false,"given":"Konstantin E.","family":"Belozerov","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1462-6907","authenticated-orcid":false,"given":"Gleb V.","family":"Kondratiev","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7668-1282","authenticated-orcid":false,"given":"Liudmila V.","family":"Bregel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Irkutsk State Medical Academy of Postgraduate Education, Branch of Russian Medical Academy of Continuous Professional Education, Irkutsk 664049, Russia"},{"name":"Department of Cardiology, Irkutsk Regional Children\u2019s Hospital, Irkutsk 664022, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-9942","authenticated-orcid":false,"given":"Olesya S.","family":"Efremova","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Irkutsk State Medical Academy of Postgraduate Education, Branch of Russian Medical Academy of Continuous Professional Education, Irkutsk 664049, Russia"},{"name":"Department of Cardiology, Irkutsk Regional Children\u2019s Hospital, Irkutsk 664022, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7965-7002","authenticated-orcid":false,"given":"Alla A.","family":"Vilnits","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"},{"name":"The Research Department of Intensive Care of Emergency Conditions, Pediatric Research and Clinical Center for Infection Diseases, Saint Petersburg 197022, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0422-2060","authenticated-orcid":false,"given":"Julia E.","family":"Konstantinova","sequence":"additional","affiliation":[{"name":"The Research Department of Vaccination and Adverse Event Follow Immunization, Pediatric Research and Clinical Center for Infection Diseases, Saint Petersburg 197022, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0911-7817","authenticated-orcid":false,"given":"Eugenia A.","family":"Isupova","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6238-4121","authenticated-orcid":false,"given":"Tatiana L.","family":"Kornishina","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3703-4920","authenticated-orcid":false,"given":"Vera V.","family":"Masalova","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7780-8871","authenticated-orcid":false,"given":"Eugeniy Yu.","family":"Felker","sequence":"additional","affiliation":[{"name":"Intensive Care Unite Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8683-4270","authenticated-orcid":false,"given":"Olga V.","family":"Kalashnikova","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5776-1490","authenticated-orcid":false,"given":"Vyacheslav G.","family":"Chasnyk","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-4813","authenticated-orcid":false,"given":"Yuriy S.","family":"Aleksandrovich","sequence":"additional","affiliation":[{"name":"Intensive Care Unite Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1180-8086","authenticated-orcid":false,"given":"Mikhail M.","family":"Kostik","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/apa.15270","article-title":"Systematic review of COVID-19 in children shows milder cases and a better 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