Background: Multisystem inflammatory syndrome in children (MIS-C) secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has affected not only the older children, adolescents and adults but also infants, more so during the second wave of the global pandemic.

Objectives: To alert the clinicians to the early diagnosis of MIS-C by lowering the threshold for its diagnosis in compatible clinical settings and timely institution of IVIg in these vulnerable infants to prevent the morbidity and long term complications.

Methods: All sequentially admitted infants hospitalized during a period of 6 months, who fulfilled the WHO criteria for MIS-C or AHA 2017 criteria for Kawasaki Disease (and positive COVID serology) were included in the present study.

Results: A total of 19 infants were studied. 13 (68.3%) had evidence of recent COVID-19 infection. The median age of presentation was 2 months (IQR 25 ^th , 75 ^th 0.5, 3). The most common presenting symptoms were fever (68.4%), gastrointestinal complaints (63.1%) and edema (36.8%). Other predominant signs were shock (78.9%), myocarditis (52.6%) and neurological complaints (26.3%). Incomplete Kawasaki disease was present in 21% patients. Elevated CRP, ferritin, D-Dimer, NT pro BNP and reduced fibrinogen were markers of severe illness. All subjects received IVIG (100%), 31.5% received a second dose of IVIG and 63.1% received pulse intravenous methylprednisolone. A total of 5(26.3%) died as a result of the disease process.

Conclusion: The spectrum of MIS-C in infants can be varied and is different from older children. A high index of suspicion is therefore needed in infants who present with critical illness and don’t respond appropriately to conventional antibiotics and supportive care. Addition of IVIG and corticosteroids to the treatment regimen leads to favourable outcome.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.