Page 176 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

P-EPIC-030
Case Series: Mild to Severe Clinical Spectrums of Children with COVID-19
Related Multisystem Inflammatory Syndrome

Felix Liauw, Pustika Efar, Endah Citraresmi, Winda Azwani, Citra Raditha, Dimas Dwi Saputro,
Rifan Fauzie, Amar Widhiani
Department of Child Health, Harapan Kita Women and Children Hospital, Jakarta, Indonesia

Abstract
Background In general, children infected to coronavirus (COVID-19) have mild symptoms than adult.
However, they may suffer to severe systemic hyperinflammatory complication defined as multisystem
inflammatory syndrome in children (MIS-C). Objective TO report the case series of 8 children diagnosed
with MIS-C in a tertiary care children’s hospital. Methods MIS-C was diagnosed according to Center for
Disease Control case definition. Clinical features, laboratory findings, and outcomes of MIS-C patients
admitted to Harapan Kita Women and Children hospital, Jakarta, Indonesia from January to January to June
2021 were reviewed. Results Our patients have varied ages from 1 months to 11 years. Only one child was
previously healthy with no comorbid. Fever were the most common symptoms (5 from 8 children), followed
by gastrointestinal symptoms (4). Ascending paralysis resembles Guillain Barre was found in one child and
Kawasaki-like skin rash disease also in one child. The organs complication most commonly involved were
cardiovascular, hematology, and gastroenterology. Laboratory findings showed thrombocytopenia 10,000-
133,000/µL (6/8), elevated CRP 5.4-7.8 mg/L (6/8), ferritin 82.79-7478.59 ng/mL (8/8), D-dimer 534-10,000
mg/L (4/6), and NT-proBNP 1908-463,284 ng/L (6/6). Six children were admitted to intensive care unit due
to shock requiring inotropic/vasopressor agents (3), respiratory failure with ventilator support (2), decrease
of consciousness (1,) and severe bleeding (1). Methylprednisolone (6) and intravenous immunoglobulin (1)
were prescribed, while one child received none of them due to death before 24 hours admission. Six children
survived; however, we did not perform any follow up for sequalae. Conclusion Our case series performed
wide clinical features of MIS-C. The fatality rate was quite high with most of them required intensive care.
Early recognition and careful assessment of MIS-C are necessary in order to administering proper treatment.
Keywords: multisystem inflammatory in children (MIS-C); coronavirus (COVID-19)

P-EPIC-031
The association between obesity and dengue severity among pediatric patients

Thadea Tandi, Ronald Rompies, Adrian Umboh
Department of Child Health, Medical Faculty, Universitas Sam Ratulangi/Prof. DR. R. D. Kandou Hospital,
Manado, North Sulawesi, Indonesia
Abstract
Background Dengue is an acute systemic viral infection caused by the dengue virus. Severe dengue infection
often has unpredictable clinical progressions and outcomes. Obesity may play a role in the deterioration
of dengue infection due to stronger body immune responses. Objective To assess the relationship between
obesity and outcome in patients with dengue shock syndrome. Methods This study used a retrospective cross
sectional study method on 151 children who were treated in the Pediatric Intensive Care Unit of Prof. Dr.
R. D Kandou Manado from January to December 2020. By assessing the outcome of dengue hemorrhagic
fever shock patients with nutritional status. Data were analyzed using IBM SPSS Statistics version 28.0
and logistic regression analysis. Results We found 151 children suffering from dengue hemorrhagic fever
with shock during the period January to December 2020. From 151 patients there were 10 children with
obese nutritional status and 140 non-obese children. From 10 obese children, we found 6 (60%) children
died while being treated in the PICU while for non-obese children there were 2 (1.4%) who died. For the
outcome showed obesity could significantly increase the mortality compared to the non-obese children (OR
104.2; 95% CI 15.84 to 685.85;P=<.001) Conclusion This review found that obesity is a risk factor for
dengue severity among children. There is a very significant relationship between obesity and mortality in
children with dengue shock syndrome. The result highlights and improves our understanding that obesity
might influence the severity of dengue infection.
Keywords: obesity; dengue shock syndrome; children

128 KONIKA XVIII Abstract Book