Multisystem Inflammatory Syndrome In Children at Sohag University Hospital

NCT05382234 | Unknown

• 1 other identifier: Soh-Med-22-05-12
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Since its initial description in December 2019 in Wuhan , China, Corona virus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), has rapidly evolved into a worldwide pandemic affecting millions of lives . Unlike adults, the vast majority of children with COVID-19 have mild symptoms. However, there are children who have significant respiratory disease, and some children may develop a hyper inflammatory response similar to what has been observed in adults with COVID-19. Furthermore, in late April 2020, reports emerged of children with a different clinical syndrome resembling Kawasaki disease (KD) and toxic shock syndrome; these patients frequently had evidence of prior exposure to SARS-CoV-2. The pathophysiology of MIS-C: Is unclear ,but it appears to be a consequence of a exacerbated immune system response or maladaptive response of the host .After the virus enters the human cells, the first line of defense against infection should be a quick and well-coordinated immune response ;however, when this mechanism is unregulated and excessive ,hyper inflammation can occur. Cytokines that play an important role in inducing immunity and immunopathology during infections in excess can cause the clinical syndrome known as cytokine storm. The inflammatory response caused by SARS-CoV-2appears to be the major cause of mortality in infected patients . The infection of dendritic cells or macrophages by SARS-CoV-2 induces the production of low levels of antiviral cytokines and increases the production of inflammatory cytokines (tumor necrosis factor\[TNF\], interleukin\[IL\]-1, IL-6,and interferon ).

Conditions

Multisystem Inflammatory Syndrome in Children

Outcome Measures

Primary Outcomes (1)

• Confirmed or suspected cases of Multisystem inflammatory syndrome in children

  Confirmed or suspected cases Multisystem inflammatory syndrome in children based On WHO Criteria of MIS-C 1. Age 0-19 years. 2. Fever for ≥3 days. 3. Clinical signs of multi system involvement (at least 2 of the following): 1. Rash, bilateral non purulent conjunctivitis, or mucocutaneous inflammation signs 2. Hypotension or shock 3. Evidence of coagulopathy (prolonged PT or PTT) 4. Acute gastrointestinal symptoms (diarrhea , vomiting, or abdominal pain) 4. Elevated markers of inflammation (eg ESR, CRP) 5. No other obvious microbial cause of inflammation. 6. Evidence of SARS-CoV-2 infection (Any of the following: Positive SARS-CoV-2 RT-PCR ,positive serology, COVID 19 exposure within the 4 weeks prior to the onset of symptoms). according to CDC criteria exposure to a patients with suspected or confirmed COVID-19 within the 4 weeks prior to the onset of symptoms.

  1 year

Interventions

CBC, ESR ,CRP,Liver Function ,renal function ,ABG,Na,K,D-dimmer ,cardiac enzyme,ferritin ,blood and urine culture in negative cases DIAGNOSTIC_TEST

cllinical and laboratory evaluation of MIS-C,Effectivness of different therapeutic modalities,Outcome of cases (morbidity,mortality)

Eligibility Criteria

• Age: 1 Day - 12 Years
• Sex: all
• Age Groups: Child (0-17)
• Sampling Method: Non-Probability Sample

Study Population

Multisystem inflammatory syndrome in children

You may qualify if:

• Any suspected case of MIS-C from birth to 12 year included both sexes fulfill criteria of MIS-C (WHO) .
• Fever for ≥3 days.
• Clinical signs of multi system involvement (at least 2 of the following):
• Rash, bilateral non purulent conjunctivitis, or mucocutaneou inflammation signs (oral, hands, or feet)
• Hypotension or shock
• Cardiac dysfunction, pericarditis, valvulitis , or coronary abnormalities (including echocardiographic findings or elevated troponin)
• Evidence of coagulopathy (prolonged PT or PTT)
• Acute gastrointestinal symptoms (diarrhea , vomiting, or abdominal pain)
• \. Elevated markers of inflammation (eg ESR, CRP) 5. No other obvious microbial cause of inflammation. 6. Evidence of SARS-CoV-2 infection (Any of the following: Positive SARS-CoV-2 RT-PCR ,positive serology, COVID 19 exposure within the 4 weeks prior to the onset of symptoms).
• according to CDC criteria exposure to a patients with suspected or confirmed COVID-19 within the 4 weeks prior to the onset of symptoms.

You may not qualify if:

• Other obvious microbial cause of inflammation, including bacterial sepsis and staphylococcal/streptococcal toxic shock syndromes.

Sponsors & Collaborators

• Sohag University: lead

Study Sites (1)

Sohag university hospital

Sohag, Egypt

Location

Related Publications (4)

• Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020 May;20(5):533-534. doi: 10.1016/S1473-3099(20)30120-1. Epub 2020 Feb 19. No abstract available.

  PMID: 32087114 BACKGROUND

• Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020 May 23;395(10237):1607-1608. doi: 10.1016/S0140-6736(20)31094-1. Epub 2020 May 7. No abstract available.

  PMID: 32386565 BACKGROUND

• Alunno A, Carubbi F, Rodriguez-Carrio J. Storm, typhoon, cyclone or hurricane in patients with COVID-19? Beware of the same storm that has a different origin. RMD Open. 2020 May;6(1):e001295. doi: 10.1136/rmdopen-2020-001295.

  PMID: 32423970 BACKGROUND

• Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017 Jul;39(5):529-539. doi: 10.1007/s00281-017-0629-x. Epub 2017 May 2.

  PMID: 28466096 BACKGROUND

MeSH Terms

Conditions

pediatric multisystem inflammatory disease, COVID-19 related

Interventions

Blood Cell Count

Intervention Hierarchy (Ancestors)

Cell Count; Cytological Techniques; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Hematologic Tests; Investigative Techniques; Cell Physiological Phenomena; Blood Physiological Phenomena; Circulatory and Respiratory Physiological Phenomena

Central Study Contacts

Youstina R Attia, residant

CONTACT

01275866826; youstinarashed@med.sohag.edu.eg

Osama R Elsherief, Professor

CONTACT

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Resident docotor pediatric department Facuity Of Medicine Sohag University

Study Record Dates

• First Submitted: May 15, 2022
• First Posted: May 19, 2022
• Study Start: June 1, 2022
• Primary Completion: June 1, 2023
• Study Completion: June 1, 2023
• Last Updated: May 19, 2022

Record last verified: 2022-05

Locations

EG (1)