Clinical Characteristics and Factors Associated with Unfavorable Outcomes of Pediatric Inflammatory Multisystem Syndrome Related to COVID-19 in Lima-Peru

Abstract Objective: Describe the clinical-epidemiological profile and determine the factors associated with unfavorable outcomes of pediatrics multisystemic inflammatory syndrome (SIM-P) related to COVID-19 at Edgardo Rebagliati Martins National Hospital (HNERM), Lima-Perú, from April to September 2020. Materials and methods: Retrospective cohort in children under 14 years of age. The current criteria were used for the diagnosis of SIM-P. The effect size was estimated with relative risk (RR) and 95% confidence intervals, using a generalized linear Poisson family model with robust variance. Results: 43 patients were included, 22 (51.2%) Kawasaki Disease (EK), 10 (23.3%) shock, and 11(25.6%) fever with inflammatory markers. The median age was 8 years, most men, without comorbidity, with negative molecular test and positive IgG. Gastrointestinal and mucocutaneous manifestations predominated, with altered inflammatory markers and myocardial injury. Most required intravenous immunoglobulin (IVIG), aspirin (AAS), corticosteroids and antibiotics. More than a third required VMI, ICU and developed organic dysfunction, with a lethality of 4.6% (2/43). Increasing lethality to 20% (2/10) in the shock subgroup. Five were found (14.7%) coronary aneurysm. Having some comorbidity (RR 1.79; IC95%1.02-3.14), C-reactive protein ≥ 10 mg/dL (RR 2.09; IC95%1.15-3.79), and SatO2 ≤92 in emergency (RR 2.84; IC95%1.47-5.50) was morelikely to betransferred to ICU. In addition, those with some comorability (RR 2.23; IC95%1.04-4.79), with lymphopenia <500cel/mL (RR 2.8; IC95%1.24-6.30), and with d≥ 3 mg/L (RR 3.57; IC95%1.23-10.38) were more likely to require VMI. Conclusion: Active monitoringis an eye to make early diagnosis and management in order to improve the prognosis.