Obesity and Clinical Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) in Northern Iran

 Obesity has been recognized as a risk factor for COVID-19 infection in children. Multisystem Inflammatory Syndrome in Children (MIS-C) is a multisystem inflammatory disease following COVID-19, characterized by the involvement of at least two organs. Considering the significant role of obesity in the severity of COVID-19, this study investigates the prevalence of obesity and the factors affecting it in MIS-C patients.

This descriptive study included MIS-C patients younger than 21 years of age from December 2019 to September 2023. The patients were identified using the Centers for Disease Control and Prevention (CDC) checklist. Based on growth charts developed by the World Health Organization (WHO), the classification of overweight and obese children was determined according to the age and sex of each child. The demographic characteristics, clinical features, and outcomes were collected from the medical records. Data were analyzed using the t-test (or Mann-Whitney), Chi-square test, and logistic regression in STATA 14.

A total of 174 MIS-C patients were referred to hospitals, of whom height and weight measurements were documented for 149 patients. Of these, 11.41% of patients were overweight, and 17.45% were classified as obese. The median age was 62 months, and most of the patients were boys. The most common symptoms were gastrointestinal. In terms of clinical outcomes, ICU admission, death, and the median hospital stay in the obese group were 60%, 2%, and nine days, respectively, while in the non-obese group, they were 22%, 0.94%, and eight days, respectively. Significant differences were observed between the two groups in cardiac symptoms, comorbidity, duration of hospitalization, length of ICU stay, and need for ICU care (P<0.05). In the adjusted model, comorbidity was identified as a significant predictor (OR= 6.17; 95% CI: 0.34, 16.24).

The study's results indicate that obesity is associated with more severe clinical presentations and outcomes among MIS-C patients. Consequently, early intervention is crucial for preventing complications in obese MIS-C patients.