Hospitalization outcomes and laboratory correlations in pediatric MIS-C patients: a retrospective cross-sectional study in Tehran, Iran

Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe and potentially fatal condition. This study aimed to evaluate the clinical features and laboratory data of affected children. This cross-sectional study was conducted from 2020 to 2021 at a referral center in Tehran, Iran. Patients meeting the MIS-C criteria with initial laboratory parameters, including Alanine Aminotransferase (ALT), lymphocyte count, ferritin, Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), and albumin, were included. The relationships with outcomes such as duration of admission, intensive care unit (ICU) admission, respiratory support, acute kidney injury, and persistent cardiac problems were assessed using independent t-tests, chi-square tests, Pearson correlation coefficient, and logistic regression. Among 100 pediatric MIS-C patients, 26 patients require PICU admission. The majority of patients presented with mucocutaneous (85%) and gastrointestinal (83%) symptoms. Ferritin and CRP levels were significantly associated with longer hospital stays (p = 0.001 and p = 0.02, respectively) and the need for respiratory support (p < 0.001, p = 0.003). Ferritin, ESR, and ALT levels were significantly related to the need for PICU admission (p = 0.004, p = 0.002, and p < 0.001). Further analysis revealed significant associations between less commonly studied ratios and clinical outcomes: the CRP/albumin ratio was associated with PICU admission (p < 0.001), hospital duration (p = 0.04), and respiratory support (p < 0.001); ferritin/ESR ratio correlated with PICU admission (p < 0.001) and hospital duration (p < 0.001); and the ALT/Lymphocyte ratio was linked to hospital duration (p < 0.001), though it was not significantly related to PICU admission (p = 0.36) or respiratory support (p = 0.77). Key laboratory markers and ratios are associated with disease severity in MIS-C, aiding in identifying high-risk patients and guiding treatment.