Clinical Phenotype and Outcomes of Multisystem Inflammatory Syndrome in Children According to SARS‐CoV‐2 Laboratory Status During 2020–2021: A Retrospective Observational Study
- 1Pediatric Infections Research Center, Research Institute for Children's Health Shahid Beheshti University of Medical Sciences Tehran Iran
- 2Iranian Research Center for HIV/AIDS Tehran University of Medical Sciences Tehran Iran
- 3Department of Pediatrics, School of Medicine Lorestan University of Medical Sciences Khorramabad Iran
Abstract
Background and Aims: Multisystem inflammatory syndrome in children (MIS‐C) is a post‐infectious inflammatory condition associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) that can affect multiple organ systems. Data comparing clinical features and outcomes between MIS‐C patients with and without laboratory evidence of coronavirus disease 2019 (COVID‐19) remain limited.
Methods: This retrospective observational study was conducted at Mofid Children's Hospital, a pediatric referral center in Tehran, Iran, between March 2020 and July 2021. Children diagnosed with MIS‐C based on World Health Organization (WHO) criteria were included and classified into groups with and without laboratory evidence of SARS‐CoV‐2 infection according to PCR and/or IgG serology results. Demographic data, clinical manifestations, laboratory and imaging findings, treatments, and outcomes were compared between the groups using univariate and multivariable analyses. A p‐value < 0.05 was considered statistically significant.
Results: A total of 121 patients with MIS‐C were included, of whom 44 (36.4%) had laboratory evidence of SARS‐CoV‐2 infection. The mean age was 4.74 ± 3.99 years, and 61.2% were male. ICU admission occurred in 21.5% and mortality was 2.5%. In univariate analysis, fever during the first 24 h of hospitalization and antiviral use were more frequent in the group with laboratory evidence, whereas conjunctivitis and elevated C‐reactive protein levels were more common among the group without laboratory evidence; however, CRP did not differ significantly between groups when analyzed as a continuous variable. In multivariable analysis, fever during the first 24 h of hospitalization was the only variable associated with laboratory evidence of SARS‐CoV‐2 infection (aOR 2.57; 95% CI 1.05–6.30; p = 0.040).
Conclusion: MIS‐C presents with broad and largely overlapping clinical, laboratory, and imaging features regardless of SARS‐CoV‐2 laboratory status, and the few observed differences were exploratory and of limited discriminative value. These findings highlight the importance of considering MIS‐C even in the absence of laboratory confirmation of SARS‐CoV‐2 infection.
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BibTeX
@article{armin2026clinical,
title = {{Clinical Phenotype and Outcomes of Multisystem Inflammatory Syndrome in Children According to SARS‐CoV‐2 Laboratory Status During 2020–2021: A Retrospective Observational Study}},
author = {Shahnaz Armin and Seyede Mahsan Hoseini‐Alfatemi and Roxana Mansour Ghanaiee and Abdollah Karimi and Negin Rahimidanesh and Arian Ashnaei and Amirata Fakhfouri and Azadeh Jafrasteh and Yasna Soleimani},
journal = {Health Science Reports},
year = {2026},
month = nov,
doi = {10.1002/hsr2.73483},
url = {https://doi.org/10.1002/hsr2.73483},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Clinical Phenotype and Outcomes of Multisystem Inflammatory Syndrome in Children According to SARS‐CoV‐2 Laboratory Status During 2020–2021: A Retrospective Observational Study
AU - Shahnaz Armin
AU - Seyede Mahsan Hoseini‐Alfatemi
AU - Roxana Mansour Ghanaiee
AU - Abdollah Karimi
AU - Negin Rahimidanesh
AU - Arian Ashnaei
AU - Amirata Fakhfouri
AU - Azadeh Jafrasteh
AU - Yasna Soleimani
PY - 2026
DA - 2026/11/05
JO - Health Science Reports
DO - 10.1002/hsr2.73483
UR - https://doi.org/10.1002/hsr2.73483
AB - Background and Aims: Multisystem inflammatory syndrome in children (MIS‐C) is a post‐infectious inflammatory condition associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) that can affect multiple organ systems. Data comparing clinical features and outcomes between MIS‐C patients with and without laboratory evidence of coronavirus disease 2019 (COVID‐19) remain limited. Methods: This retrospective observational study was conducted at Mofid Children's Hospital, a pediatric referral center in Tehran, Iran, between March 2020 and July 2021. Children diagnosed with MIS‐C based on World Health Organization (WHO) criteria were included and classified into groups with and without laboratory evidence of SARS‐CoV‐2 infection according to PCR and/or IgG serology results. Demographic data, clinical manifestations, laboratory and imaging findings, treatments, and outcomes were compared between the groups using univariate and multivariable analyses. A p‐value < 0.05 was considered statistically significant. Results: A total of 121 patients with MIS‐C were included, of whom 44 (36.4%) had laboratory evidence of SARS‐CoV‐2 infection. The mean age was 4.74 ± 3.99 years, and 61.2% were male. ICU admission occurred in 21.5% and mortality was 2.5%. In univariate analysis, fever during the first 24 h of hospitalization and antiviral use were more frequent in the group with laboratory evidence, whereas conjunctivitis and elevated C‐reactive protein levels were more common among the group without laboratory evidence; however, CRP did not differ significantly between groups when analyzed as a continuous variable. In multivariable analysis, fever during the first 24 h of hospitalization was the only variable associated with laboratory evidence of SARS‐CoV‐2 infection (aOR 2.57; 95% CI 1.05–6.30; p = 0.040). Conclusion: MIS‐C presents with broad and largely overlapping clinical, laboratory, and imaging features regardless of SARS‐CoV‐2 laboratory status, and the few observed differences were exploratory and of limited discriminative value. These findings highlight the importance of considering MIS‐C even in the absence of laboratory confirmation of SARS‐CoV‐2 infection.
SN - 2398-8835
ER -