COVID-19 and Multisystem Inflammatory Syndrome in Latin American Children: A Multinational Study.

Antúnez-Montes, Omar Yassef; Escamilla, Maria Isabel; Figueroa-Uribe, Augusto Flavio; Arteaga-Menchaca, Erick; Lavariega-Saráchaga, Manuel; Salcedo-Lozada, Perla; Melchior, Priscilla; de Oliveira, Rodrigo Beréa; Tirado Caballero, Juan Carlos; Redondo, Hernando Pinzon; Montes Fontalvo, Laura Vanessa; Hernandez, Roger; Chavez, Carolina; Campos, Francisco; Uribe, Fadia; Del Aguila, Olguita; Rios Aida, Jorge Alberto; Buitrago, Andrea Parra; Betancur Londoño, Lina Maria; Mendoza Vega, León Felipe; Hernández, Carolina Almeida; Sali, Michela; Higuita Palacio, Julian Esteban; Gomez-Vargas, Jessica; Yock-Corrales, Adriana; Buonsenso, Danilo

BACKGROUND To date, there are no comprehensive data on pediatric COVID-19 from Latin America. This study aims to assess COVID-19 and Multisystem Inflammatory Syndrome (MIS-C) in Latin American children, to appropriately plan and allocate resources to face the pandemic on a local and international level. METHODS Ambispective multicenter cohort study from 5 Latin American countries. Children 18 years of age or younger with microbiologically confirmed SARS-CoV-2 infection or fulfilling MIS-C definition were included. FINDINGS Four hundred nine children were included, with a median age of 3.0 years (interquartile range 0.6-9.0). Of these, 95 (23.2%) were diagnosed with MIS-C. One hundred ninety-one (46.7%) children were admitted to hospital and 52 (12.7%) required admission to a pediatric intensive care unit. Ninety-two (22.5%) patients required oxygen support: 8 (2%) were started on continuous positive airway pressure and 29 (7%) on mechanical ventilation. Thirty-five (8.5%) patients required inotropic support. The following factors were associated with pediatric intensive care unit admission: preexisting medical condition (P < 0.0001), immunodeficiency (P = 0.01), lower respiratory tract infection (P < 0.0001), gastrointestinal symptoms (P = 0.006), radiological changes suggestive of pneumonia and acute respiratory distress syndrome (P < 0.0001) and low socioeconomic conditions (P = 0.009). CONCLUSIONS This study shows a generally more severe form of COVID-19 and a high number of MIS-C in Latin American children, compared with studies from China, Europe and North America, and support current evidence of a more severe disease in Latin/Hispanic children or in people of lower socioeconomic level. The findings highlight an urgent need for more data on COVID-19 in Latin America.