4CPS-213 Characteristics of multisystem inflammatory syndrome in children versus Kawasaki on clinical aspects, specificities and treatment

• Published in: European journal of hospital pharmacy. Science and practice 2023-03, Vol.30 (Suppl 1), p.A95-A95
• Main Authors: Hanafia, O, Ghandour, A, Honoré, S, Bertault-Peres, P
• Format: Article
• Language: English
• Subjects: Conflicts of interest; Coronaviruses; Drug therapy; Intensive care; Multisystem inflammatory syndrome in children; Pediatrics; Section 4: Clinical pharmacy services; Steroids
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2023-eahp.199

Background and ImportanceSince the Coronavirus (COVID-19) pandemic, there has been a high number of children hospitalised in the paediatric intensive care unit (PICU) for Paediatric Multisystemic Inflammatory Syndrome (MIS-C) resembling Kawasaki Disease (KD)Aim and ObjectivesThe objectives of this study were to describe the clinic and the therapeutics that we used in PIMS, compared to those of KD. To describe the impact of the treatments used and discuss the clinical evolution of our patientsMaterial and MethodsThis is a retrospective observational study in the paediatric intensive care unit, over a 9-month period from April to December 2020. The clinical, biological and medication data was collected via the computerised patient record, our presence in the department and thanks to the prescription software for PIMS patients and compared to the KD data of the scientific literatureResultsWe included 12 children, median age 8 years [2 -16 years] and sex ratio = 2, diagnosed with MIS-C. Negative PCR tests on admission and presence of anti-SRAS-CoV-2 antibodies in all patients. All presented fever, with a mean duration of 5 days. 5 patients presented 2 clinical criteria characteristic of KD insufficient to diagnose complete KD. Gastrointestinal symptoms (10 patients), rarely seen in KD. All had inflammatory and cardiac markers higher than those in KD. Cardiac damage was observed in 10 patients: 50% had persistent systemic hypotension and 5 had ECG abnormalities. Drug therapy was to reduce inflammation. 9 patients received intravenous immunoglobulin (IVIG), 5 patients received a 2nd dose of IVIG and 2 a 3rd dose. Corticosteroid therapy for 4 days was administered to 10 patients and 9 required anti-inflammatory treatment with acetylsalicylic acid. These treatments, combined with vasopressor or diuretic and anticoagulant support, were necessary. There were no deaths in our cohort, the average time of management in the department was 6 days [2-13 days].Conclusion and RelevanceOur patients described a clinical picture suggesting KD, with a broader symptomatology and severity, much more marked inflammatory and cardiac markers, a shorter fever, a lower platelet count, more frequent gastrointestinal involvement, the median age of our cohort was higher. The therapeutic strategy: IGIV and corticosteroid therapy appeared to be effective in our studyReferences and/or AcknowledgementsConflict of InterestNo conflict of interest