Ophthalmic Manifestations of Multisystem Inflammatory Syndrome in Children

Abstract

Objective The aims of this study were to determine the prevalence and clinical features of ophthalmic involvement in multisystem inflammatory syndrome in children (MIS-C) and to evaluate its association with other organ system involvement and the severity of the disease.

Methods The demographic data and information on the ophthalmologic and other systemic organ manifestations, laboratory findings, treatment modalities, and clinical outcomes of 97 patients with MIS-C were retrospectively obtained from their hospital records. Sixty-two patients with MIS-C who were examined by ophthalmologists were included in the study. Statistical analysis was performed using R version 3.6.0, and a p-value < 0.05 was accepted as statistically significant.

Results The patients' median age was 82 months (range, 11–204 months). Of the patients, 62.9% were male. The most common systemic involvements were mucocutaneous (83.9%) and cardiovascular (82.3%). Kawasaki disease was clinically observed in 71% of the patients (incomplete form, 53.2%). Ophthalmic involvement was observed in 39 patients (62.9%). Thirty-two patients (51.6%) had conjunctival hyperemia; 29 (48.4%) lid edema; 7 follicular conjunctivitis; 3 uveitis; 2 subconjunctival hemorrhage; and 1 episcleritis. The patients with ophthalmic involvement were 6.4 times (95% confidence interval [CI], 1.49–27.48; p = 0.013) more likely to exhibit cardiac involvement and 3.53 times (95% CI, 1.35–9.63; p = 0.012) more likely to have severe disease.

Conclusion Conjunctival hyperemia, lid edema, and follicular conjunctivitis were observed in at least half of the patients with MIS-C, and those with ophthalmic involvement had a higher risk of cardiac involvement or severe disease.

Keywords

COVID-19 - multisystem - inflammatory syndrome in children - ophthalmic manifestation - cardiac involvement

Availability of Data and Material

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

Code Availability

All source codes are available within the article [and/or] its supplementary materials.

Authors' Contributions

M.E. was responsible for substantial contributions to conception and design, acquisition of data, analysis, and interpretation of data; and drafting the article and revising it critically for important intellectual content.

B.B. was responsible for substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; and drafting the article;

S.A.D. was responsible for substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; and revising it critically for important intellectual content;

G.A. was responsible for substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; and revising it critically for important intellectual content.

S.K.T.O. was responsible for substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; and revising it critically for important intellectual content.

A.S. was responsible for substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; and revising it critically for important intellectual content.

M.K.K. was responsible for substantial contributions to conception and design, acquisition of data, analysis and interpretation of data; and revising it critically for important intellectual content.

We further confirm that any aspect of the work covered in this manuscript that has involved either experimental animals or human patients has been conducted with the ethical approval of all relevant bodies and that such approvals are acknowledged within the manuscript.

Ethical Approval

The study protocols were approved by the Selcuk University Faculty of Medicine ethics committee

Consent to Participate

We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

Consent for Publication

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. The manuscript is not under publication or consideration for publication elsewhere.

Publication History

Received: 08 November 2022

Accepted: 31 March 2023

Article published online:
01 May 2023

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