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Browsing by Author "Calderon, Johanna"
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Item Neurological and Psychological Sequelae Associated With Multisystem Inflammatory Syndrome in Children(American Medical Association, 2023-07-03) Rollins, Caitlin K.; Calderon, Johanna; Wypij, David; Taylor, Alex M.; Kanjiker, Tahera Sultana Davalji; Rohde, Julia S.; Maiman, Moshe; Zambrano, Laura D.; Newhams, Margaret M.; Rodriguez, Susan; Hart, Nicholas; Worhach, Jennifer; Kucukak, Suden; Poussaint, Tina Y.; Son, Mary Beth F.; Friedman, Matthew L.; Gertz, Shira J.; Hobbs, Charlotte V.; Kong, Michele; Maddux, Aline B.; McGuire, Jennifer L.; Licht, Paul A.; Allen Staat, Mary; Yonker, Lael M.; Mazumdar, Maitreyi; Randolph, Adrienne G.; Campbell, Angela P.; Newburger, Jane W.; Overcoming COVID-19 Investigators; Pediatrics, School of MedicineImportance: Acute neurological involvement occurs in some patients with multisystem inflammatory syndrome in children (MIS-C), but few data report neurological and psychological sequelae, and no investigations include direct assessments of cognitive function 6 to 12 months after discharge. Objective: To characterize neurological, psychological, and quality of life sequelae after MIS-C. Design, setting, and participants: This cross-sectional cohort study was conducted in the US and Canada. Participants included children with MIS-C diagnosed from November 2020 through November 2021, 6 to 12 months after hospital discharge, and their sibling or community controls, when available. Data analysis was performed from August 2022 to May 2023. Exposure: Diagnosis of MIS-C. Main outcomes and measures: A central study site remotely administered a onetime neurological examination and in-depth neuropsychological assessment including measures of cognition, behavior, quality of life, and daily function. Generalized estimating equations, accounting for matching, assessed for group differences. Results: Sixty-four patients with MIS-C (mean [SD] age, 11.5 [3.9] years; 20 girls [31%]) and 44 control participants (mean [SD] age, 12.6 [3.7] years; 20 girls [45%]) were enrolled. The MIS-C group exhibited abnormalities on neurological examination more frequently than controls (15 of 61 children [25%] vs 3 of 43 children [7%]; odds ratio, 4.7; 95% CI, 1.3-16.7). Although the 2 groups performed similarly on most cognitive measures, the MIS-C group scored lower on the National Institutes of Health Cognition Toolbox List Sort Working Memory Test, a measure of executive functioning (mean [SD] scores, 96.1 [14.3] vs 103.1 [10.5]). Parents reported worse psychological outcomes in cases compared with controls, particularly higher scores for depression symptoms (mean [SD] scores, 52.6 [13.1] vs 47.8 [9.4]) and somatization (mean [SD] scores, 55.5 [15.5] vs 47.0 [7.6]). Self-reported (mean [SD] scores, 79.6 [13.1] vs 85.5 [12.3]) and parent-reported (mean [SD] scores, 80.3 [15.5] vs 88.6 [13.0]) quality of life scores were also lower in cases than controls. Conclusions and relevance: In this cohort study, compared with contemporaneous sibling or community controls, patients with MIS-C had more abnormal neurologic examinations, worse working memory scores, more somatization and depression symptoms, and lower quality of life 6 to 12 months after hospital discharge. Although these findings need to be confirmed in larger studies, enhanced monitoring may be warranted for early identification and treatment of neurological and psychological symptoms.