Author: Michael A. Evans, MD – Ann & Robert H. Lurie Children’s Hospital of Chicago
A Hispanic male presents to the emergency room with tachypnea and a fever of 40° Celsius. A SARS-CoV-2 RT-PCR is positive. Blood tests reveal an elevated C-reactive protein (CRP) and B-type natriuretic peptide (BNP). Which of the following age groups does this patient MOST LIKELY belong to based on the demographics of patients with Multisystem Inflammatory Syndrome in Children (MIS-C)?
Correct!
Wrong!
Question of the Week 318
According to the Centers for Disease Control and Prevention (CDC) as of May 2021, the majority of the 3742 cases of MIS-C have occurred in children and adolescents between the ages of one and fourteen years old with a median of nine years. There have been 35 MIS-C deaths to date. The cases are broken down by age group in the following table.
Age Range-------------------------------% of Cases
Less than 1 year of age------------------3%
1 to 4 years of age-----------------------21%
5 to 9 years of age-----------------------34%
10 to 14 years of age---------------------27%
15 to 20 years of age---------------------15%
MIS-C has a slight predominance in males (60% of cases) and children of Hispanic/Latino descent (33%) or Black/Non-Hispanic descent (30%) versus White/Non-Hispanic descent (28%).
The diagnostic criteria for MIS-C are as follows:
• Patient aged <21 years with fever or history of fever and laboratory evidence of inflammation [elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), interleukin 6 (IL-6), or neutrophils; reduced lymphocytes, or low albumin], and evidence of clinically severe illness requiring hospitalization with multisystem organ involvement (≥2 of the following systems: cardiac, respiratory, renal, gastrointestinal, neurologic, hematologic, or dermatologic), AND
• Current or recent SARS-CoV-2 infection or COVID-19 exposure within 4 weeks of symptom onset, AND
• No alternative plausible diagnoses
References
1. National Center for Immunization and Respiratory Diseases (NCIRD). Health Department-Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/mis-c/cases/index.html. Updated May 11, 2021. Accessed May 16, 2021.
2. Belhadjer Z, Meot M, Bajolle F, et al. Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic. Circulation. 2020; 142(4): 429–436.
3. National Center for Immunization and Respiratory Diseases (NCIRD). Information for Healthcare Providers about Multisystem Inflammatory Syndrome in Children (MIS-C). Centers for Disease Control and Prevention. https://www.cdc.gov/MIS-C/hcp/. Updated February 21, 2021. Accessed May 16, 2021.
Age Range-------------------------------% of Cases
Less than 1 year of age------------------3%
1 to 4 years of age-----------------------21%
5 to 9 years of age-----------------------34%
10 to 14 years of age---------------------27%
15 to 20 years of age---------------------15%
MIS-C has a slight predominance in males (60% of cases) and children of Hispanic/Latino descent (33%) or Black/Non-Hispanic descent (30%) versus White/Non-Hispanic descent (28%).
The diagnostic criteria for MIS-C are as follows:
• Patient aged <21 years with fever or history of fever and laboratory evidence of inflammation [elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), interleukin 6 (IL-6), or neutrophils; reduced lymphocytes, or low albumin], and evidence of clinically severe illness requiring hospitalization with multisystem organ involvement (≥2 of the following systems: cardiac, respiratory, renal, gastrointestinal, neurologic, hematologic, or dermatologic), AND
• Current or recent SARS-CoV-2 infection or COVID-19 exposure within 4 weeks of symptom onset, AND
• No alternative plausible diagnoses
References
1. National Center for Immunization and Respiratory Diseases (NCIRD). Health Department-Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/mis-c/cases/index.html. Updated May 11, 2021. Accessed May 16, 2021.
2. Belhadjer Z, Meot M, Bajolle F, et al. Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic. Circulation. 2020; 142(4): 429–436.
3. National Center for Immunization and Respiratory Diseases (NCIRD). Information for Healthcare Providers about Multisystem Inflammatory Syndrome in Children (MIS-C). Centers for Disease Control and Prevention. https://www.cdc.gov/MIS-C/hcp/. Updated February 21, 2021. Accessed May 16, 2021.
