Epidemiology, clinical characteristics and outcomes of multisystem inflammatory syndrome in children

Background We describe the epidemiology, clinical characteristics, and outcomes of multisystem inflammatory syndrome in children (MIS‐C) among children from Negeri Sembilan, Malaysia. Methods A retrospective, multicentre, observational study was performed among children ≤15 years old who were hospitalized for MIS‐C between January 18, 2021 and June 30, 2023. The incidence of MIS‐C was estimated using reported SARS‐CoV‐2 cases and census population data. Descriptive analyses were used to summarize the clinical presentation and outcomes. Results The study included 53 patients with a median age of 5.7 years (IQR 1.8–8.7 years); 75.5% were males. The overall incidence of MIS‐C was approximately 5.9 cases per 1,000,000 person‐months. Pediatric intensive care unit (PICU) admission was required for 22 (41.5%) patients. No mortalities were recorded. Children aged 6–12 years were more likely to present with cardiac dysfunction/shock (odds ratio [OR] 5.43, 95% confidence interval [CI] 1.67–17.66), whereas children below 6 years were more likely to present with a Kawasaki disease phenotype (OR 5.50, 95% CI 1.33–22.75). Twenty patients (37.7%) presented with involvement of at least four organ systems, but four patients (7.5%) demonstrated single‐organ system involvement. Conclusion An age‐based variation in the clinical presentation of MIS‐C was demonstrated. Our findings suggest MIS‐C could manifest in a spectrum, including single‐organ involvement. Despite the high requirement for PICU admission, the prognosis of MIS‐C was favorable, with no recorded mortalities.