Multisystem inflammatory syndrome in children: a cross-sectional study of cases and factors associated with deaths during the COVID-19 pandemic in Brazil, 2020 * * This study received financial support from the National Council for Scientific and Technological Development/Ministry of Science, Technology and Innovation, and also from the Ministry of Health, via a health professional training scholarship, as part of the Field Epidemiology Training Program Applied to Brazilian National Health System Services (EpiSUS): File No 161970/2019-2.

Laís de Almeida Relvas-Brandt Caroline Gava Fernanda Sindeaux Camelo Victor Bertollo Gomes Porto Ronaldo Fernandes Santos Alves Marcela Santos Correa Da Costa Sandra Maria Deotti Carvalho Greice Madeleine Ikeda do Carmo Francieli Fontana Sutile Tardetti Fantinato Marcelo Yoshito Wada Yluska Myrna Meneses Brandão e Mendes Martha Gonçalves Vieira Roselle Bugarin Steenhouwer Klebia Magalhães Pereira Castello Branco Maria Verônica Câmara dos Santos Ivan Romero Rivera Luiz Henrique Nicoloso Marco Aurelio Palazzi Safadi Dalva Maria de Assis About the authors

Abstract

Objective

To characterize the clinical-epidemiological profile of multisystem inflammatory syndrome in children temporally associated with COVID-19 (MIS-C), and to identify factors associated with MIS-C deaths in Brazil, 2020.

Methods

This was a cross-sectional study, using national MIS-C monitoring data. Logistical regression was performed to estimate crude and adjusted odds ratios (OR).

Results

Median case (n=652) age was 5 years, 57.1% were male, 52.0% were of brown race/skin color and 6.4% died. Likelihood of death was greater among those who presented O2 saturation <95% (ORa=4.35 – 95%CI 1.69;11.20) and altered urea results (ORa=5.18 – 95%CI 1.91;14.04); likelihood of death was lower when red skin blotches were not present (ORa=0.23 – 95%CI 0.09;0.62), when anticoagulants were used (ORa=0.32 – 95%CI 0.12;0.89) and when immunoglobulins were used (ORa=0.38 – 95%CI 0.15;1.01).

Conclusion

Fatality ratios were higher among cases that presented O2 saturation <95% and altered urea results. Fatality ratios were lower among those with red skin blotches, and those who used immunoglobulins and anticoagulants.

Coronavirus Infections; Pediatrics; Systemic Inflammatory Response Syndrome; Death; Epidemiological Monitoring; Cross-Sectional Studies

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