Objective Aim of the study is to assess the clinical characteristics and treatment outcomes of multisystem ınflammatory syndrome in children (MIS-C) associated with COVID-19. Study design The study comprised 52 children with MIS-C admitted to University of Health Sciences Adana City Training and Research Hospital pediatric wards from September 2020 to April 2021. Demographic characteristics and clinical data were retrospectively collected from patient files. Results Median age of patients was 9 (5–13) years. Fever (92.3%), abdominal pain (76.9%), rash (48.1%) and vomiting (48.1%) were the most common presenting symptoms. Fever duration was 8 (4.25–10) days in overall. Depressed left ventricular ejection fraction was found in 17.3% of patients. At admission, elevated levels of C-reactive protein, procalcitonine, erythrocyte sedimentation rate, D-dimer and ferritin were found in 98.1%, 96.2%, 75%, 84.6% and 69.2% of the patients, respectively. Lymphopenia, hyponatremia and hypoalbuminemia were found in 76.9%, 59.6% and 42.3% of the patients. Intravenous immunoglobulin was used in 96.2%, corticosteroids in 71.2% and anakinra in 3.8% of the patients. In total, 28.8% of the patients were admitted to pediatric intensive care unit and 17.3% received vasopressor support. Median duration of hospital length of stay was 12.5 days. Comorbidities were present in 19.2% of the patients. No mortality was recorded. Conclusions While being rare and treatable, MIS-C is the ugly and mysterious face of the COVID-19 pandemic for children. The increasing number of MIS-C cases shows that this phenomenon is more common than thought. Comprehensive studies are required to understand the pathogenesis of the disease and determine the treatment regimens clearly. Lay summary While being rare and treatable, multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 is the ugly and mysterious face of the COVID-19 pandemic for children. MIS-C is now thought to be a post-infectious (SARS-CoV2) hyperinflammatory disease secondary to an abnormal immune response, rather than a complete obscurity. The increasing number of MIS-C cases and new case series reports from all over the world show that MIS-C is more common than thought. Despite our increasing experience, we may encounter a new finding every day in MIS-C patients. Therefore, we want to contribute to literature by presenting the MIS-C cases we treated in our clinic in detail. We have experienced that MIS-C patients can apply with similar but also different and unique characteristics. In case of delayed diagnosis or treatment, morbidity and mortality rates may increase. Therefore, the level of awareness and knowledge of all physicians, especially those dealing with pediatric patients, about MIS-C should be increased. Although the early effects of MIS-C are known, we don’t have enough information about the long-term consequences yet. Comprehensive studies are required to understand the pathogenesis of the disease and determine the treatment regimens clearly.

中文翻译：

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与 COVID-19 相关的儿童多系统炎症综合征 (MIS-C)：土耳其南部三级护理医院的病例系列经验

目的 本研究的目的是评估与 COVID-19 相关的儿童多系统炎症综合征 (MIS-C) 的临床特征和治疗结果。研究设 结果 患者的中位年龄为 9 (5-13) 岁。发热（92.3%）、腹痛（76.9%）、皮疹（48.1%）和呕吐（48.1%）是最常见的症状。总体发热持续时间为 8 (4.25-10) 天。17.3% 的患者发现左心室射血分数降低。入院时，C反应蛋白、降钙素原、红细胞沉降率、分别有 98.1%、96.2%、75%、84.6% 和 69.2% 的患者发现 D-二聚体和铁蛋白。76.9%、59.6%和42.3%的患者出现淋巴细胞减少、低钠血症和低白蛋白血症。96.2% 的患者使用静脉内免疫球蛋白，71.2% 的患者使用皮质类固醇，3.8% 的患者使用阿那白滞素。总共有 28.8% 的患者入住儿科重症监护室，17.3% 的患者接受了血管加压药支持。住院时间中位数为 12.5 天。19.2% 的患者存在合并症。没有死亡记录。结论 MIS-C 虽然罕见且可治疗，但对于儿童而言，它是 COVID-19 大流行的丑陋而神秘的面孔。越来越多的 MIS-C 案例表明，这种现象比想象的要普遍。需要进行综合研究以了解疾病的发病机制并明确确定治疗方案。总结 虽然罕见且可治疗，但与 COVID-19 相关的儿童多系统炎症综合征 (MIS-C) 是儿童 COVID-19 大流行的丑陋而神秘的面孔。MIS-C 现在被认为是一种继发于异常免疫反应的感染后 (SARS-CoV2) 高炎症性疾病，而不是完全模糊不清。越来越多的 MIS-C 病例和来自世界各地的新病例系列报告表明 MIS-C 比想象的更普遍。尽管我们的经验越来越多，但我们可能每天都会在 MIS-C 患者中遇到新发现。因此，我们希望通过详细介绍我们在诊所治疗的 MIS-C 病例来为文献做出贡献。我们已经体验到 MIS-C 患者可以应用具有相似但也不同和独特的特征。如果延误诊断或治疗，发病率和死亡率可能会增加。因此，应提高所有医生，尤其是与儿科患者打交道的医生对 MIS-C 的认识和知识水平。虽然 MIS-C 的早期影响是已知的，但我们还没有足够的关于长期后果的信息。需要进行综合研究以了解疾病的发病机制并明确确定治疗方案。尤其是那些处理儿科患者的，关于MIS-C应该增加。虽然 MIS-C 的早期影响是已知的，但我们还没有足够的关于长期后果的信息。需要进行综合研究以了解疾病的发病机制并明确确定治疗方案。尤其是那些处理儿科患者的，关于MIS-C应该增加。虽然 MIS-C 的早期影响是已知的，但我们还没有足够的关于长期后果的信息。需要进行综合研究以了解疾病的发病机制并明确确定治疗方案。