Observational studyWorld journal of pediatrics : WJP2023
Impact of time to diagnosis on the occurrence of cardiogenic shock in MIS-C post-COVID-19 infection.
Observational study in World journal of pediatrics : WJP, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Prevalence, Comparative Risk, and Predictors of Shock in Children With Multisystem Inflammatory Syndrome Associated With COVID-19: A Systematic Review and Meta-Analysis.Journal of paediatrics and child health · 2026Pooled it
- A Novel ApoB/ApoA1 Ratio-Integrated Nomogram to Predict Cardiogenic Shock After Acute Myocardial Infarction.Reviews in cardiovascular medicine · 2026Article
- Cardiogenic Shock Risk Score at Diagnosis of Multisystem Inflammatory Syndrome in Children: A Multicenter Study.Pediatric cardiology · 2026Observational
- Progress on diagnosis and treatment of multisystem inflammatory syndrome in children.Frontiers in immunology · 2025Review
- Case Report: Two episodes of hyperinflammation in an infant consistent with multisystem inflammatory syndrome in children: recurrence or rather two different diseases?Frontiers in pediatrics · 2025Article
- Clinical Significance of B-Type Natriuretic Peptide and N-Terminal Pro-B-Type Natriuretic Peptide in Pediatric Patients: Insights into Their Utility in the Presence or Absence of Pre-Existing Heart Conditions.International journal of molecular sciences · 2024Review
- Treatment of multisystem inflammatory syndrome in children.World journal of pediatrics : WJP · 2024Review
- Baseline Echocardiography and Laboratory Findings in MIS-C and Associations with Clinical Illness Severity.Pediatric cardiology · 2024Article
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn multisystem inflammatory syndrome in children (MIS-C), diagnostic delay could be associated with severity. This study aims to measure the time to diagnosis in MIS-C, assess its impact on the occurrence of cardiogenic shock, and specify its determinants.
methodsA single-center prospective cohort observational study was conducted between May 2020 and July 2022 at a tertiary care hospital. Children meeting the World Health Organization MIS-C criteria were included. A long time to diagnosis was defined as six days or more. Data on time to diagnosis were collected by two independent physicians. The primary outcome was the occurrence of cardiogenic shock. Logistic regression and receiver operating characteristic curve analysis were used for outcomes, and a Cox proportional hazards model was used for determinants.
resultsTotally 60 children were assessed for inclusion, and 31 were finally analyzed [52% males, median age 8.8 (5.7-10.7) years]. The median time to diagnosis was 5.3 (4.2-6.2) days. In univariable analysis, age above the median, time to diagnosis, high C-reactive protein, and high N-terminal pro-B-type natriuretic peptide (NT-proBNP) were associated with cardiogenic shock [odds ratio (OR) 6.13 (1.02-36.9), 2.79 (1.15-6.74), 2.08 (1.05-4.12), and 1.70 (1.04-2.78), respectively]. In multivariable analysis, time to diagnosis ≥ 6 days was associated with cardiogenic shock [adjusted OR (aOR) 21.2 (1.98-227)]. Time to diagnosis ≥ 6 days had a sensitivity of 89% and a specificity of 77% in predicting cardiogenic shock; the addition of age > 8 years and NT-proBNP at diagnosis ≥ 11,254 ng/L increased the specificity to 91%. Independent determinants of short time to diagnosis were age < 8.8 years [aHR 0.34 (0.13-0.88)], short distance to tertiary care hospital [aHR 0.27 (0.08-0.92)], and the late period of the COVID-19 pandemic [aHR 2.48 (1.05-5.85)].
conclusionsTime to diagnosis ≥ 6 days was independently associated with cardiogenic shock in MIS-C. Early diagnosis and treatment are crucial to avoid the use of inotropes and limit morbidity, especially in older children.
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