Chris Carroll MD Profile picture
#PedsICU Critical Care Doc. Deputy Editor @journal_CHEST. Father, educator, #zentensivist, @kate_moorehead’s husband. he/him. 🏳️‍🌈🏳️‍⚧️ally. Opinions own

Aug 25, 2022, 9 tweets

The big impact of a disease in little kids. Characteristics & Outcomes of Multisystem Inflammatory Syndrome in the #PedsICU. Great work @kindly_kel @picudoc13 @DrKenRemy1 @RBC_PICU @MKleinBiostats @JanineZeeCheng @ColinRogerson5 @AlexRotta @caseymccluskey journals.lww.com/pccmjournal/Fu…

#MIS_C is a clinical syndrome of systemic inflammation that occurs 4–6 weeks after exposure to #SARSCoV2 affecting the heart, lungs, kidneys, brain, skin, and GI system. Review by @MontyMazer @yoncabulutmd @nina_brodsky @drsturge @RBC_PICU @DrKenRemy1 journals.lww.com/pccmjournal/pa…

In this paper, we used the @vps_llc to track trends in #MIS_C in 115 #pedsICU’s since the beginning of the pandemic, and compared outcomes over time (and by strain). Of the 145,580 children admitted to the PICU, 1,338 children (0.9%) were admitted with #MISC.

In this cohort, the disease burden for #MIS_C was high with an overall median hospital LOS of 6.6 days (IQR 4.7-9.3) and a median #pedsICU LOS of 2.7 days (IQR 1.6-4.7). Overall 15.2% of children with #MISC were intubated & mechanically ventilated. There were 11 hospital deaths.

There was a significant decrease in hospital & #PedsICU LOS and frequency of intubation in children with #MISC between Quarter 3 and 4 of 2020. Driving factors for this decrease may have been due to improvement in therapeutic interventions, increased recognition, or viral strain.

Given the timing of the spread of the different viral strains, an improved understanding of MIS-C is a more likely explanation for improved outcomes. The predominant viral strain of #SARSCoV2 changed in Q1 of 2021, after the observed improvement in outcomes.

From May 2020 to early 2021, there was a rapid growth in understanding of #MIS_C and dissemination of knowledge. @Twitter helped! (as @AnnaZanin_MD @Nopanaden @MiguelrrMD @LaCampo4 @rolandoug @mevillar @sgdambrauskas @sapnaKmd have already shown!) #pedsICU journals.lww.com/pccmjournal/Fu…

Please see the link below for a copy of the full paper. And thanks to @PedCritCareMed for publishing this! And to my co-authors @kindly_kel @picudoc13 @DrKenRemy1 @RBC_PICU @MKleinBiostats @JanineZeeCheng @ColinRogerson5 @AlexRotta @caseymccluskey #pedsICU journals.lww.com/pccmjournal/Fu…

This marks the FIFTH (!) paper from the PEACE group. Involvement in with this group has been one of the great professional experiences of my career. I’m continually amazed at everyone's collaborative spirit, insightfulness and productivity. Excited to see what the future holds!

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