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The HyperPed-COVID international registry: Impact of age of onset, disease presentation and geographical distribution on the final outcome of MIS-C
R. Caorsi, A. Consolaro, C. Speziani, B. Sozeri, K. Ulu, E. Faugier-Fuentes, H. Menchaca-Aguayo, S. Ozen, S. Sener, S. Akhter Rahman, M. Imnul Islam, F. Haerynck, G. Simonini, MV. Mastri, T. Avcin, S. Sršen, T. de Albuquerque Pedrosa Fernandes,...
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
- MeSH
- COVID-19 * epidemiology mortality complications MeSH
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Registries * MeSH
- Retrospective Studies MeSH
- SARS-CoV-2 * MeSH
- Systemic Inflammatory Response Syndrome * epidemiology diagnosis therapy MeSH
- Age of Onset * MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Infant, Newborn MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
OBJECTIVES: The aim of the study was to establish an international multicenter registry to collect data on patients with Multisystem Inflammatory Syndrome in Children (MIS-C), in order to highlight a relationship between clinical presentation, age of onset and geographical distribution on the clinical outcome. STUDY DESIGN: Multicenter retrospective study involving different international societies for rare immunological disorders.1009 patients diagnosed with MIS-C between March and September 2022, from 48 centers and 22 countries were collected. Five age groups (<1, 1-4, 5-11, 12-16, >16 years) and four geographic macro-areas, Western Europe, Central-Eastern Europe, Latin America, Asian-African resource-limited countries (LRC), were identified. RESULTS: Time to referral was significantly higher in LRC. Intensive anti-inflammatory treatment, including biologics, respiratory support and mechanic ventilation were more frequently used in older children and in European countries. The mortality rate was higher in very young children (<1 year), in older patients (>16 years of age) and in LRC. Multivariate analysis identified the residence in LRC, presence of severe cardiac involvement, renal hypertension, lymphopenia and non-use of heparin prophylaxis, as the factors most strongly associated with unfavorable outcomes. CONCLUSIONS: The stratification of patients by age and geographic macro-area provided insights into the clinical presentation, treatment and outcome of MIS-C. The mortality and sequelae rates exhibited a correlation with the age and geographical areas. Patients admitted and treated in LRC displayed more severe outcomes, possibly due to delays in hospital admission and limited access to biologic drugs and to intensive care facilities.
Amruta Hospital Pediatrics Rajkot India
ASST Papa Giovanni XXIII Bergamo Italy
Bangabandhu Sheikh Mujib Medical Universit Dhaka Bangladesh
Bangabandhu Sheikh Mujib Medical University Paediatrics Dhaka Bangladesh
Cattolica Sacro Cuore University Roma Italy
České Budějovice Hospital Ceske Budejovice Czech Republic
Children Hospital G Di Cristina Palermo Italy
Children's Regional Clinical Hospital in Dnipro Dnipro Ukraine
Clinica Pediatrica Dell'Università di Brescia Spedali Civili Brescia Italy
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
General University Hospital and 1st Faculty of Medicine Charles University Prague Czech Republic
Gent University Hospital Gent Belgium
Gent University Hospital Pediatric Rheumatology Gent Belgium
Hacettepe University Children's Hospital Ankara Turkey
Hospital Das Clínicas Botucatu Medicine University UNESP Botucatu Brazil
Hospital Infantil de México Federico Gómez Medicina Interna y Reumatologia Mexico City Mexico
Hospital México Americano Guadalajara Mexico
Hospital Santa Maria Lisbon Portugal
Hospital Sao Joao Porto Portugal
Hospital Universitario Dr J E Gonzalez Universidad Autónoma de Nuevo León Monterrey NL Mexico
Institute of Child and Maternal Health IRCCS Burlo Garofolo and University of Trieste Trieste Italy
IRCCS Istituto Giannina Gaslini Direzione Scientifica Genoa Italy
IRCCS Istituto Giannina Gaslini UOC Reumatologia e Malattie Autoinfiammatorie Genoa Italy
IRCCS Meyer Children's Hospital Rheumatology Unit ERN ReCONNECT Center Florence Italy
IRCCS Ospedale Pediatrico Bambino Gesù Division of Rheumatology Rome Italy
Mansoura University Children's Hospital Faculty of Medicine Mansoura University Mansura Egypt
Mansoura University Faculty of Medicine Mansoura Egypt
Mansoura University Mansoura Egypt
National Pirogov Memorial Medical University Vinnytsia Ukraine
P a A Kyriakou Children's Hospital Athens Greece
Pediatrics Clinic University of Brescia and ASST Spedali Civili di Brescia Brescia Italy
Regina Margherita Children Hospital Immunology and Rheumatology Unit Turin Italy
Riga Stradins University Children University Hospital Riga Latvia
Rigshospitalet Copenhagen Denmark
Saint Petersburg State Pediatric Medical Academy Saint Petersburg Russian Federation
São Paulo State University Botucatu Brazil
State Institution Scientific Center of Children Health of Rams Moscow Moscow Russian Federation
Tajnsek University Children's Hospital University Medical Centre Ljubljana Ljubljana Slovenia
Ternopil Regional Children's Hospital Ternopil Ukraine
Thomayer University Hospital Prague Czech Republic
Translational Immunology Institute Singapore Singapore
UCL GOS Institute of Child Health London UK
Universidade Federal Do Rio de Janeiro Rio de Janeiro Brazil
Universitiy Hospital Centre Split Split Croatia
University Children Hospital Department of Paediatric Rheumatology Sofia Bulgaria
University Children Hospital Riga Latvia
University Children Hospital Sofia Bulgaria
University Hospital Centre Split Department of Pediatrics Split Croatia
University Hospital Centre Zagreb University School of Medicine Zagreb Croatia
University Hospital Hradec Kralove Department of Pediatrics Hradec Kralove Czech Republic
University Hospital Hradec Kralove Hradec Kralove Czech Republic
University of Genoa Department of Health Sciences Genoa Italy
UZ Leuven Universitair Ziekenhuis Leuven Belgium
Varna Medical University Department of Pediatrics 1st Pediatric Clinic Varna Bulgaria
Western Ukrainian Specialized Children's Medical Centre Lviv Ukraine
References provided by Crossref.org
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- $a The HyperPed-COVID international registry: Impact of age of onset, disease presentation and geographical distribution on the final outcome of MIS-C / $c R. Caorsi, A. Consolaro, C. Speziani, B. Sozeri, K. Ulu, E. Faugier-Fuentes, H. Menchaca-Aguayo, S. Ozen, S. Sener, S. Akhter Rahman, M. Imnul Islam, F. Haerynck, G. Simonini, MV. Mastri, T. Avcin, S. Sršen, T. de Albuquerque Pedrosa Fernandes, V. Stanevicha, J. Vojinovic, A. Sobh, S. Fingerhutova, L. Minxova, A. Gagro, A. Rodrigues Fonseca, D. Pandya, B. Varbanova, J. Sánchez-Manubens, M. Ganeva, D. Montin, O. Boyarchuk, A. Minghini, C. Bracaglia, P. Brogan, F. Candotti, M. Cattalini, I. Meyts, F. Minoia, A. Taddio, C. Wouters, F. De Benedetti, F. Bovis, A. Ravelli, N. Ruperto, M. Gattorno, HyperPED-COVID study group, ERN-RITA (European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases), PReS (Pediatric Rheumatology European Society), ESID (European Society for Immunodeficiencies), ISSAID (International Society of Systemic Auto-Inflammatory Diseases) and the, **Paediatric Rheumatology International Trials Organisation (PRINTO), Y. Bilginer, K. Laila, MM. Islam, B. Meertens, L. Hoste, J. Dehoorne, P. Schelstraete, K. Vandekerckhove, J. Willems, I. Matthijs, G. Filocamo E Gisella Beatrice Beretta, CS. Magalhaes, O. Chubata, F. Ricci, A. Vukovic, K. Temelkova, MZ. Avramovic, N. Emersic, M. Bizjak, T. Vesel, MF. Rodrigues, R. Gasparello de Almeida, K. Lukjanovica, MH. Elnagdy, A. Soliman, E. Terifajova, I. Brejchova, M. Magner, C. Myrup, O. Vougiouka, M. Jelusic, F. La Torre, D. Rigante, MC. Maggio, L. Verdoni, N. Rubio-Perez, GV. Cornejo, AV. Villarreal Trevino, I. Brito, F. Oliveira-Ramos, E. Alexeeva, V. Chasnyk, T. Arkachaisri, Y. Boyko, Y. Vyzhga, S. Samsonenko
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- $a OBJECTIVES: The aim of the study was to establish an international multicenter registry to collect data on patients with Multisystem Inflammatory Syndrome in Children (MIS-C), in order to highlight a relationship between clinical presentation, age of onset and geographical distribution on the clinical outcome. STUDY DESIGN: Multicenter retrospective study involving different international societies for rare immunological disorders.1009 patients diagnosed with MIS-C between March and September 2022, from 48 centers and 22 countries were collected. Five age groups (<1, 1-4, 5-11, 12-16, >16 years) and four geographic macro-areas, Western Europe, Central-Eastern Europe, Latin America, Asian-African resource-limited countries (LRC), were identified. RESULTS: Time to referral was significantly higher in LRC. Intensive anti-inflammatory treatment, including biologics, respiratory support and mechanic ventilation were more frequently used in older children and in European countries. The mortality rate was higher in very young children (<1 year), in older patients (>16 years of age) and in LRC. Multivariate analysis identified the residence in LRC, presence of severe cardiac involvement, renal hypertension, lymphopenia and non-use of heparin prophylaxis, as the factors most strongly associated with unfavorable outcomes. CONCLUSIONS: The stratification of patients by age and geographic macro-area provided insights into the clinical presentation, treatment and outcome of MIS-C. The mortality and sequelae rates exhibited a correlation with the age and geographical areas. Patients admitted and treated in LRC displayed more severe outcomes, possibly due to delays in hospital admission and limited access to biologic drugs and to intensive care facilities.
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