Clinical Management Strategies and Outcomes of Multisystem Inflammatory Syndrome in Children: Experience from Ngoerah Hospital

Abstract Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but severe post-coronavirus disease 2019 (COVID-19) condition, affecting fewer than 1% of pediatric Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections. There is limited research on MIS-C clinical management strategies and outcomes. Objectives: This study describes MIS-C clinical outcomes and the association between clinical management strategies and outcomes. Methods: The study was delivered at Ngoerah Hospital, designed as a cross-sectional observational analysis. The population was MISC patients who were admitted from September 2021 to July 2024, included those who were aged 0–18 years and excluded cases with bacterial infections. Data were collected from electronic medical records. Bivariate analysis was utilized to assess associations between independent variables and patient outcomes using Chi-Square or Fisher’s exact tests, with α < 0.05. Results: There were 63 children, 35 (55.6%) were males and 28 (44.4%) females. Overall survival was 87.4%. Four key factors showed significant associations with mortality: pediatric intensive care unit (PICU) admission ( P = 0.007), number of collaborating divisions ( P = 0.010), presence of comorbidities ( P < 0.001), and COVID-19 vaccination history ( P = 0.02). Conclusions: Extensive multidisciplinary involvement, the presence of underlying comorbidities, admission to PICU, and lack of COVID-19 vaccination were all associated with poorer outcomes in MIS-C patients. These findings highlight the importance of early identification of high-risk children and the implementation of streamlined, coordinated care pathways, especially for those with complex clinical presentations, to improve survival in MIS-C.