Evaluation and follow-up in functionality in patients with Pediatric Multisystem Inflammatory Syndrome associated with COVID-19 (MIS-C)

In June 2020 appeared the first cases of Multisystem Inflammatory Syndrome in Children (MISC) associated with COVID-19 in Chile. Possible sequelae associated with this condition are still unknown. Objective: To describe the functional status of children with MIS-C admitted to a high complexity Hospital. Patients and Method: Descriptive, prospective study. Sample of 28 patients. The functional status was evaluated during Hospitalization, and in the first and fourth months after discharge with the Functional Status Scale (FSS), Pediatric Evaluation of Disability Inventory (PEDI-CAT), 6-minute walk test (6MWT), PImax and PEmax, and dynamometry. Post-Traumatic Stress Disorder was screened with the Child PTSD Symptom Scale (CPSS). Results: Mean age 63.6 months. Sixteen were women and 60.7% presented no comorbidities. Half of the cases presented with Shock. Mean hospitalization was 9 days. Twenty-two patients were admitted to the ICU; 54% required mechanical ventilation and/or vasoactive drugs, and 82% had cardiac repercussions. During hospitalization, 82.3% presented some physical alteration, 29.1% of them were confirmed ICU-acquired weakness (ICU-AW), and 16.6% were suspected cases. Thirteen patients presented emotional symptoms, 39.2% had post-ICU syndrome. Most of the patients (58.8%) had an unfavorable Functional Situation and recovered 4 months post-discharge. All patients reversed echocardiographic abnormalities in the first month and regained muscle strength in the fourth month. 38.5% of subjects reported suboptimal values in the 6MWT and 66.6% presented alteration in the post-traumatic stress screening. Conclusion: Most of the patients presented functional compromise with favorable recovery despite the severity of the symptoms and possible secondary complications after ICU.