Factors Associated With PICU Admission In Children With Multisystem Inflammatory Syndrome (MIS-C): An Observational Cohort Study

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Published Mar 2, 2025
https://doi.org/10.62438/tunismed.v103i3.5381
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Vol. 103 No. 3 (2025): Tunis Med Mar 2025

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Aida Borgi
Pediatric intensive care unit, Children’s Hospital Bechir Hamza of Tunis, University of Tunis of EL-Manar, Faculty of Medicine of Tunis,Tunis, Tunisia
Amal Miraoui
Pediatric intensive care unit, Children’s Hospital Bechir Hamza of Tunis, University of Tunis of EL-Manar, Faculty of Medicine of Tunis,Tunis, Tunisia
Rahma Guedri
Pediatric, Emergency and Outpatient Department, Children’s Hospital Bechir Hamza of Tunis, University of Tunis of EL-Manar- Faculty of Medicine of Tunis,Tunis, Tunisia
Yosr Ayedi
Department of Epidemiology and Biostatics, Abderahmen Mami Hospital, Ariana, University of Tunis of EL-Manar- Faculty of Medicine of Tunis, Tunis, Tunisia
Hela Boudabbous
Pediatric department, La Rabta Hospital,University of Tunis of EL-Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
Assaad Louati
Pediatric intensive care unit, Children’s Hospital Bechir Hamza of Tunis, University of Tunis of EL-Manar, Faculty of Medicine of Tunis,Tunis, Tunisia
Khaled Menif
Pediatric intensive care unit, Children’s Hospital Bechir Hamza of Tunis, University of Tunis of EL-Manar, Faculty of Medicine of Tunis,Tunis, Tunisia
Zohra Fitouri
Pediatric, Emergency and Outpatient Department, Children’s Hospital Bechir Hamza of Tunis, University of Tunis of EL-Manar- Faculty of Medicine of Tunis,Tunis, Tunisia

Abstract

Purpose: To investigate factors associated with Pediatric Intensive Care Unit (PICU) admission in children with severe MIS-C.


Methods: We conducted an observational cohort study between July 1, 2020, and May 31, 2021, in the only pediatric hospital in Tunisia.


Results: A total of 45 children (33 males) with no recent history of COVID-19 infection were included. Mean age was 7±3.2 years. Sixteen patients (35%) required PICU admission. There was no significant difference in mean age of patients with and without PICU admission (7.5±2.7 vs. 6.76±3.46 years; p=0.4). The frequency of respiratory distress (p=0.001), shock (p=0.001), cardiac dysfunction (p=0.003), mean CRP (p=0.001), and median troponin (p=0.003) were significantly higher in patients with PICU admission than in those without. The independent predictive factor for PICU admission was cardiac dysfunction; adjusted Odds Ratio (aOR) = 12.8, 95% CI = (2.1-76.4), p=0.002.


Conclusion: The only independent risk factor for PICU admission in patients with MIS-C was cardiac dysfunction.

Keywords:

Africa, COVID-19, children, intensive care, multisystem inflammatory disease, northern

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