Clinical Manifestations, Treatment and Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Single-Center Experience from Iran

Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C) is a documented complication arising from SARS-CoV-2 infection. Even pediatric patients who present with mild initial COVID-19 symptoms may subsequently experience severe morbidity or mortality due to MIS-C; therefore, early identification and prompt clinical management are essential for achieving favorable outcomes. This study aimed to assess the clinical characteristics, therapeutic strategies, and patient outcomes among children diagnosed with MIS-C in Yazd, Iran.

Methods: This study included all pediatric patients admitted to Shahid Sadoughi Hospital in Yazd, Iran, who presented with either suspected or confirmed MIS-C between March 2020 and March 2021. Comprehensive data were extracted from medical records, including demographics, clinical symptoms, laboratory biomarkers, imaging results, and treatment modalities.

Results: The study included 40 children (52.5% males, 47.5% females, median age 7.3 years). Fever was the predominant symptom (87.5%), followed by gastrointestinal complaints (57.5%) and mucocutaneous abnormalities (20%). The digestive, respiratory, and neurological systems were most frequently involved. Hospitalisation lasted 1–7 days in 75% and 8–14 days in 22.5% of patients. Disease severity was severe in 25%, moderate in 47.5%, and mild in 27.5%. Remdesivir (40%), corticosteroids (52.5%), and intravenous immunoglobulin (47.5%) were used as treatment. Notably, the overall mortality rate was 22.5% (9/40), substantially higher than the rates reported in most international studies.

Conclusion: This elevated mortality underscores the urgent need for enhanced early detection, rapid referral systems, and timely immunomodulatory therapy. Previous studies have reported that COVID- 19 vaccination is associated with a reduced incidence of MIS-C.