Current Pediatric Research

Introduction: Although children with coronavirus-19 disease generally experience mild disease, a subset of them develop Multisystem Inflammatory Syndrome(MIS-C). There is relative rarity of literature regarding Acute Kidney Injury (AKI) in MIS-C. We aim to characterize the clinical features, laboratory findings and therapies for AKI in MIS-C in our setup.

Materials and Methods: This was a 2-year study, with children who had AKI and met the criteria for MIS-C based on CDC guidelines.

Results: There were a total of seven cases (age ranging between 4 years to 20 years). Persistent fever was present in all patients. Six had vomiting/diarrhoea along with rashes and/or swelling of hands. Myocardial involvement was seen in four, respiratory in two and musculoskeletal in one patient. Oropharyngeal swab for SARS-Cov2 RNA was negative in all. Anticovid antibodies were positive in five and two had a history of contact with COVID-19 patients. AKI Stage 1 was present in 3, stage 2 and 3 in 2 patients each. Neutrophilia with lymphopenia was seen in all and thrombocytopenia in 4 patients. Laboratory findings for inflammatory markers showed marked elevation of C-reactive protein, ferritin, procalcitonin, ESR, fibrinogen, LDH and D-Dimer. The patients were treated with a combination of steroids, IVIg and inotropic support wherever needed. All of the patients recovered with a median duration hospital stay of 7(IQR 5) days.

Conclusion: Children with covid-19 infection should be carefully followed for MIS-C. Although children with MIS-C develop AKI, most of them have full clinical recovery. The long term prognosis of this syndrome is currently unknown and require extensive studies.

Author(s):

Zafirah Zahir, Asif Sadiq Wani, Ishaq Malik, Mohsin Fayaz Bhat, Tazeen Jeelani, Aiffa Aiman, Rukhsana Akhtar

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