Snooks, KellieScanlon, Matthew C.Remy, Kenneth E.Shein, Steven L.Klein , Margaret J.Zee-Cheng, JanineRogerson, Colin M.Rotta, Alexandre T.Lin, AnnaMcCluskey, Casey K.Carroll , Christopher L.2024-05-222024-05-222022-11Snooks, K., Scanlon, M. C., Remy, K. E., Shein, S. L., Klein, M. J., Zee-Cheng, J., Rogerson, C. M., Rotta, A. T., Lin, A., McCluskey, C. K., & Carroll, C. L. (2022). Characteristics and Outcomes of Critically Ill Children With Multisystem Inflammatory Syndrome. Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 23(11), e530–e535. https://doi.org/10.1097/PCC.0000000000003054https://hdl.handle.net/1805/40955Objectives: To characterize the prevalence of pediatric critical illness from multisystem inflammatory syndrome in children (MIS-C) and to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain on outcomes. Design: Retrospective cohort study. Setting: Database evaluation using the Virtual Pediatric Systems Database. Patients: All children with MIS-C admitted to the PICU in 115 contributing hospitals between January 1, 2020, and June 30, 2021. Measurements and Main Results: Of the 145,580 children admitted to the PICU during the study period, 1,338 children (0.9%) were admitted with MIS-C with the largest numbers of children admitted in quarter 1 (Q1) of 2021 (n = 626). The original SARS-CoV-2 viral strain and the D614G Strain were the predominant strains through 2020, with Alpha B.1.1.7 predominating in Q1 and quarter 2 (Q2) of 2021. Overall, the median PICU length of stay (LOS) was 2.7 days (25–75% interquartile range [IQR], 1.6–4.7 d) with a median hospital LOS of 6.6 days (25–75% IQR, 4.7–9.3 d); 15.2% received mechanical ventilation with a median duration of mechanical ventilation of 3.1 days (25–75% IQR, 1.9–5.8 d), and there were 11 hospital deaths. During the study period, there was a significant decrease in the median PICU and hospital LOS and a decrease in the frequency of mechanical ventilation, with the most significant decrease occurring between quarter 3 and quarter 4 (Q4) of 2020. Children admitted to a PICU from the general care floor or from another ICU/step-down unit had longer PICU LOS than those admitted directly from an emergency department. Conclusions: Overall mortality from MIS-C was low, but the disease burden was high. There was a peak in MIS-C cases during Q1 of 2021, following a shift in viral strains in Q1 of 2021. However, an improvement in MIS-C outcomes starting in Q4 of 2020 suggests that viral strain was not the driving factor for outcomes in this population.en-USPublisher PolicyCOVID-19epidemiologyinformaticsmultisystem inflammatory syndrome in childrenpediatric critical carepublic healthArticle