Collins, Angela J.Rao, MeganaKhaitan, Alka K.Bhumbra, Samina S.2023-04-172023-04-172021-07-30Collins, Angela J. Rao, Megana. Khaitan, Alka K. Bhumbra, Samina S. “Predictors of Disease Severity in Children at Riley Hospital with Multisystem Inflammatory Syndrome in Children (MIS-C).” Poster presented at: 2021 IU School of Medicine Student Research Symposium. Indianapolis, IN. July 30, 2021. Virtual.https://hdl.handle.net/1805/32432AUTHORS: Angela J. Collins, MPH, BS(1); Megana Rao, BS(1); Alka K. Khaitan, MD(2); Samina S. Bhumbra, MD(2) AFFILIATIONS: (1) Indiana University School of Medicine. (2) Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana. ABSTRACT: BACKGROUND & OBJECTIVE: Multisystem Inflammatory Syndrome in Children (MIS-C) is a novel condition temporally associated post-SARS-CoV-2-infection. The associated inflammation injures various organs (mainly cardiac and gastrointestinal) and can cause ventricular dysfunction and/or coronary aneurysms, potentially leading to death. This project assessed how lab trends may predict disease outcomes of MIS-C patients at Riley Hospital for Children (RHC). METHODS: Five lab values (intake procalcitonin, platelet count nadir, absolute lymphocyte count nadir, sodium nadir, troponin-I peak, CRP peak) were assessed as potential predictors of MIS-C severity. Patient demographics (age, sex, race, ethnicity), prior medical history (chronic conditions, obesity), and clinical presentation (days of fever prior to admission) were also assessed as potential predictors of MIS-C severity and lab peaks/nadirs. Indicators of MIS-C severity included PICU admission, length of hospital stay, left ventricular ejection fraction (EF), and abnormal coronary artery findings on echocardiogram. Chi-Square, ANOVA, linear regression, and logistic regression models were completed in SAS9.4 to assess for correlation (α=0.05). RESULTS: 66 MIS-C patients, aged 9 months to 18 years (mean=8.7 years), were admitted to RHC May 2020-April 2021. 61% were male (n=41). All patients presented with fever. Average length of stay at RHC was 5.9 days. 47% (n=31) were admitted directly to the PICU and 15% (n=10) were transferred to the PICU during their hospital course. Race predicted sodium nadir (p=0.0363), ethnicity predicted intake procalcitonin (p=0.0007), and obesity predicted CRP peak (p=0.0055). Age predicted abnormal EF (p=0.0206) and abnormal coronary outcome on echocardiogram (p=0.0365). Sex and obesity also predicted abnormal coronary outcome on echocardiogram (p=0.0182 and p=0.0478, respectively). Troponin-I peak predicted abnormal EF (p=0.0035) and CRP peak predicted days of hospital stay (p=0.0096). CONCLUSION & IMPACT: CRP peak is predictive of days of hospital stay and may inform hospital course. Analysis of additional lab values may reveal additional predictors of disease severity to inform clinical care.enAttribution 4.0 Internationalpredictordisease severityMIS-CMultisystem Inflammatory Syndrome in ChildrenCOVID-19coronavirusSARS-CoV-2KawasakiRiley Hospitaldisease outcomesConference paper