COVID Multisystem Inflammatory Syndrome in Children (MIS-C)-experience from resource-limited country

Abstract:

Multisystem inflammatory syndrome in children MIS-C is a Covid-19 postinfectious syndrome with the mainly severe presentation of multiple organ involvement, mainly the cardiovascular system. The MIS-C contributed to PICU admission due to cardiovascular instability. We treated 22 children with MIS-C on the pediatric floor of the university children's hospital, with only one short-term PICU admission due to hemodynamic instability and electrolyte disturbances. Because of illness severity and patient instability, the treatment of this group became important all around the world, and the guidelines were developed for the treatment of MIS-C, and the start point was the Kawasaki disease treatment guideline where the start treatment included only IVIG. In our department, we started combined treatment with steroids and IVIG, which brought good results to our group of children. Also, we added antibiotics due to steroid therapy and the inability to organize good separation of patients. Our experience was highly valued for our country, as treatment was organized in the pediatric department with a lower cost per patient, combined therapy helps us get good outcomes for children, and follow-up revealed no cardiovascular problems in these children. Unfortunately, we included antibiotics in treatment due to our local issues, which will be discussed during the presentation, but with no clostridia infection in this group, and we discharged mainly children home on oral steroids, as at the point of discharge we didn’t get the full stop of steroids. Aspirin prescription was also continued at home until the second and sometimes third cardiologist and lab follow-up.

Audience Take Away Notes:

• Treatment of MIS-C in a resource-limited setting with zero mortality
• Guidelines and real-life differences during the treatment course of new disease
• Organization of treatment mainly on the pediatric floor, with a lack of monitors and some lab tests as an example which can be adopted for other same-class settings before the upgrade of the facility

Biography:

Dr. Mari Darakchyan graduated from Yerevan State Medical University after M. Heratsi, faculty general medicine, and did a residency program in pediatrics and a fellowship in neonatology. Afterward, she started a Ph.D. research program at the same university supervised by Professor Pavel Mazmanyan. During her career, she fulfilled the position of neonatologist at NICU, then became head of NICU in one of Yerevan’s maternity hospitals. For more than 3 years, she is the head of the pediatric clinic in the university children’s hospital, where each year treated more than 4000 children with different pathologies. Also, she is an assistant in the pediatric department at Yerevan State Medical University. She is the author of 6 articles and 10 abstracts.