Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score

Differential diagnosis between Multisystem Inflammatory Syndrome in Children (MIS-C) and other causes of systemic inflammatory response such as sepsis is complex. The aims were to evaluate the differences between pediatric patients with MIS-C and sepsis and to develop a score to distinguish both ent...

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Autores: García Hernández, María Noelia, Roldan‐Berengue, Elies, Guitart Pardellans, Carmina, Girona, Mònica, Argüello-González, Guillermo, Pino-Otín, María Rosa, de Sevilla, Mariona F, García Machado, Juan José, Jordan, Iolanda
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2023
País:España
Recursos:Universitat Oberta de Catalunya (UOC)
Repositório:O2, repositorio institucional de la UOC
OAI Identifier:oai:openaccess.uoc.edu:10609/149161
Acesso em linha:http://hdl.handle.net/10609/149161
https://doi.org/10.1007/s00431-023-05168-w
Access Level:Acceso aberto
Palavra-chave:MIS-C
sepsis
Diagnostic score
Biomarkers
COVID-19
SARS-CoV-2
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spelling Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP scoreGarcía Hernández, María NoeliaRoldan‐Berengue, EliesGuitart Pardellans, CarminaGirona, MònicaArgüello-González, GuillermoPino-Otín, María Rosade Sevilla, Mariona FGarcía Machado, Juan JoséJordan, IolandaMIS-CsepsisDiagnostic scoreBiomarkersCOVID-19SARS-CoV-2Differential diagnosis between Multisystem Inflammatory Syndrome in Children (MIS-C) and other causes of systemic inflammatory response such as sepsis is complex. The aims were to evaluate the differences between pediatric patients with MIS-C and sepsis and to develop a score to distinguish both entities. This was a retrospective study that compared demographic, clinical, diagnostic, and therapeutic data of pediatric patients with MIS-C (cohort 2020–2022) and sepsis (cohorts 2010–2014 and 2017–2018) admitted to a Pediatric Intensive Care Unit (PICU) of a tertiary care hospital. A diagnostic score was developed with variables that differentiated the two conditions. Twenty-nine patients with MIS-C were identified, who were matched 1:3 with patients with sepsis (n = 87). Patients with MIS-C were older (10 vs. 4 years old), and the majority were male (69%). Clinical characteristics that demonstrated differences were prolonged fever and signs and symptoms affecting skin-mucosa and gastrointestinal system. Leukocytes, PCT, and ferritin were higher in sepsis, while thrombocytopenia, lymphopenia, and elevated fibrinogen and adrenomedullin (biomarker with a role for the detection of invasive infections) were more frequent in MIS-C. MIS-C patients presented greater myocardial dysfunction (p < 0.001). Five criteria were selected and included in the MISSEP score after fitting them into a multivariate logistic regression model: fever > 48 hours (20 points), thrombocytopenia < 150 × 103/µL (6 points), abdominal pain (15 points), conjunctival erythema (11 points), and Vasoactive Inotropic Score (VIS) > 10 (7 points). The cutoff > 25 points allowed to discriminate MIS-C from sepsis with a sensitivity of 0.89 and specificity of 0.95.Springer Link202320232023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10609/149161https://doi.org/10.1007/s00431-023-05168-wreponame:O2, repositorio institucional de la UOCinstname:Universitat Oberta de Catalunya (UOC)InglésEuropean Journal of Pediatrics, 2023https://doi.org/10.1007/s00431-023-05168-w© The Author(s) 2023info:eu-repo/semantics/openAccessoai:openaccess.uoc.edu:10609/1491612026-05-28T12:42:01Z
dc.title.none.fl_str_mv Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
title Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
spellingShingle Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
García Hernández, María Noelia
MIS-C
sepsis
Diagnostic score
Biomarkers
COVID-19
SARS-CoV-2
title_short Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
title_full Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
title_fullStr Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
title_full_unstemmed Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
title_sort Multisystem inflammatory syndrome in children (MIS‐C) and sepsis differentiation by a clinical and analytical score: MISSEP score
dc.creator.none.fl_str_mv García Hernández, María Noelia
Roldan‐Berengue, Elies
Guitart Pardellans, Carmina
Girona, Mònica
Argüello-González, Guillermo
Pino-Otín, María Rosa
de Sevilla, Mariona F
García Machado, Juan José
Jordan, Iolanda
author García Hernández, María Noelia
author_facet García Hernández, María Noelia
Roldan‐Berengue, Elies
Guitart Pardellans, Carmina
Girona, Mònica
Argüello-González, Guillermo
Pino-Otín, María Rosa
de Sevilla, Mariona F
García Machado, Juan José
Jordan, Iolanda
author_role author
author2 Roldan‐Berengue, Elies
Guitart Pardellans, Carmina
Girona, Mònica
Argüello-González, Guillermo
Pino-Otín, María Rosa
de Sevilla, Mariona F
García Machado, Juan José
Jordan, Iolanda
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv MIS-C
sepsis
Diagnostic score
Biomarkers
COVID-19
SARS-CoV-2
topic MIS-C
sepsis
Diagnostic score
Biomarkers
COVID-19
SARS-CoV-2
description Differential diagnosis between Multisystem Inflammatory Syndrome in Children (MIS-C) and other causes of systemic inflammatory response such as sepsis is complex. The aims were to evaluate the differences between pediatric patients with MIS-C and sepsis and to develop a score to distinguish both entities. This was a retrospective study that compared demographic, clinical, diagnostic, and therapeutic data of pediatric patients with MIS-C (cohort 2020–2022) and sepsis (cohorts 2010–2014 and 2017–2018) admitted to a Pediatric Intensive Care Unit (PICU) of a tertiary care hospital. A diagnostic score was developed with variables that differentiated the two conditions. Twenty-nine patients with MIS-C were identified, who were matched 1:3 with patients with sepsis (n = 87). Patients with MIS-C were older (10 vs. 4 years old), and the majority were male (69%). Clinical characteristics that demonstrated differences were prolonged fever and signs and symptoms affecting skin-mucosa and gastrointestinal system. Leukocytes, PCT, and ferritin were higher in sepsis, while thrombocytopenia, lymphopenia, and elevated fibrinogen and adrenomedullin (biomarker with a role for the detection of invasive infections) were more frequent in MIS-C. MIS-C patients presented greater myocardial dysfunction (p < 0.001). Five criteria were selected and included in the MISSEP score after fitting them into a multivariate logistic regression model: fever > 48 hours (20 points), thrombocytopenia < 150 × 103/µL (6 points), abdominal pain (15 points), conjunctival erythema (11 points), and Vasoactive Inotropic Score (VIS) > 10 (7 points). The cutoff > 25 points allowed to discriminate MIS-C from sepsis with a sensitivity of 0.89 and specificity of 0.95.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10609/149161
https://doi.org/10.1007/s00431-023-05168-w
url http://hdl.handle.net/10609/149161
https://doi.org/10.1007/s00431-023-05168-w
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv European Journal of Pediatrics, 2023
https://doi.org/10.1007/s00431-023-05168-w
dc.rights.none.fl_str_mv © The Author(s) 2023
info:eu-repo/semantics/openAccess
rights_invalid_str_mv © The Author(s) 2023
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Springer Link
publisher.none.fl_str_mv Springer Link
dc.source.none.fl_str_mv reponame:O2, repositorio institucional de la UOC
instname:Universitat Oberta de Catalunya (UOC)
instname_str Universitat Oberta de Catalunya (UOC)
reponame_str O2, repositorio institucional de la UOC
collection O2, repositorio institucional de la UOC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301629

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