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Abstract：
Multisystemic inflammatory syndrome in children (MIS-C) might manifest in a broad spectrum of clinical scenarios, ranging from mild features to multi-organ dysfunction and mortality. However, this novel entity has a heterogenicity of data regarding prognostic factors associated with severe outcomes. The present study aimed to identify independent predictors for severity by using multivariate regression models. A total of 391 patients (255 boys and 136 girls) were admitted to Vietnam National Children\'s Hospital from January 2022 to June 2023. The median age was 85 (range: 2-188) months, and only 12 (3.1%) patients had comorbidities. 161 (41.2%) patients required PICU admission, and the median PICU LOS was 4 (2-7) days. We observed independent factors related to PICU admission, including CRP ≥ 50 (mg/L) (OR 2.52, 95% CI 1.39-4.56, p = 0.002), albumin ≤ 30 (g/L) (OR 3.18, 95% CI 1.63-6.02, p = 0.001), absolute lymphocyte count ≤ 2 (× 109/L) (OR 2.18, 95% CI 1.29-3.71, p = 0.004), ferritin ≥ 300 (ng/mL) (OR 2.35, 95% CI 1.38-4.01), p = 0.002), and LVEF < 60 (%) (OR 2.48, 95% CI 1.28-4.78, p = 0.007). Shock developed in 140 (35.8%) patients, especially for those decreased absolute lymphocyte ≤ 2 (× 109/L) (OR 2.48, 95% CI 1.10-5.61, p = 0.029), albumin ≤ 30 (g/L) (OR 2.53, 95% CI 1.22-5.24, p = 0.013), or LVEF < 60 (%) (OR 2.24, 95% CI 1.12-4.51, p = 0.022). In conclusion, our study emphasized that absolute lymphocyte count, serum albumin, CRP, and LVEF were independent predictors for MIS-C severity. Further well-designed investigations are required to validate their efficacy in predicting MIS-C severe cases, especially compared to other parameters. As MIS-C is a new entity and severe courses may progress aggressively, identifying high-risk patients optimizes clinicians\' follow-up and management to improve disease outcomes.
摘要：
儿童多系统炎症综合征（MIS-C）可能表现在广泛的临床情景中，从轻度特征到多器官功能障碍和死亡率。然而,这个新实体在与严重结局相关的预后因素方面存在数据异质性.本研究旨在通过使用多元回归模型来确定严重程度的独立预测因子。从2022年1月至2023年6月，共有391名患者（255名男孩和136名女孩）被送往越南国家儿童医院。中位年龄为85（范围：2-188）个月，只有12例(3.1%)患者有合并症.161名（41.2%）患者需要进入PICU，PICULOS中位数为4（2-7）天。我们观察了与PICU入院相关的独立因素，包括CRP≥50（mg/L）（OR2.52，95％CI1.39-4.56，p=0.002），白蛋白≤30（g/L）（OR3.18，95%CI1.63-6.02，p=0.001），绝对淋巴细胞计数≤2（×109/L）（OR2.18，95％CI1.29-3.71，p=0.004），铁蛋白≥300（ng/mL）（OR2.35，95%CI1.38-4.01），p=0.002),LVEF<60（%）（OR2.48，95%CI1.28-4.78，p=0.007）。140例（35.8%）患者出现休克，特别是对于那些绝对淋巴细胞≤2（×109/L）（OR2.48，95％CI1.10-5.61，p=0.029），白蛋白≤30（g/L）（OR2.53，95%CI1.22-5.24，p=0.013），或LVEF<60（%）（OR2.24，95%CI1.12-4.51，p=0.022）。总之,我们的研究强调绝对淋巴细胞计数，血清白蛋白,CRP,和LVEF是MIS-C严重程度的独立预测因子。需要进一步精心设计的调查来验证其在预测MIS-C重症病例中的功效，特别是与其他参数相比。由于MIS-C是一个新实体，严峻的课程可能会取得积极进展，识别高危患者可以优化临床医生的随访和管理,从而改善疾病预后.
