Objective: To describe the clinical-epidemiological profile of Multisystem Inflammatory Syndrome in Children (MIS-C) cases and to identify factors associated with MIS-C deaths in Brazil, 2020. Methods: Cross-sectional study, based on MIS-C national monitoring database in Brazil, 2020. Simple and multiple logistic regression was performed to estimate crude and adjusted odds ratios (OR). Results: The median age of cases (n=652) was 5 years, 57.1% were male, 52.0% were brown race/color and 6.4% died. The odds of death was greater among those who presented O2 saturation <95% (ORa=4.35 – 95%CI 1.69;11.20) and altered result of urea (ORa=5.18 – 95%CI 1.91;14.04); lower in the absence of cutaneous lesion such as rash (ORa=0.23 – 95%CI 0.09;0.62), with the use of anticoagulants (ORa=0.32 – 95%CI 0.12;0.89) and of immunoglobulins (ORa=0.38 – 95%CI 0.15;1.01). Conclusion: Fatality rates was higher among cases that presented O2 saturation<95% and altered urea, and lower among those with cutaneous lesion, who used immunoglobulins and anticoagulants.

Objetivo: Caracterizar o perfil clínico-epidemiológico da síndrome inflamatória multissistêmica pediátrica temporalmente associada à COVID-19 (SIM-P) e identificar fatores associados aos óbitos de SIM-P no Brasil, 2020. Métodos: Estudo seccional, utilizando dados do monitoramento nacional da SIM-P. Empregou-se regressão logística para estimar razões de chances (ORs, odds ratios) brutas e ajustadas. Resultados: Os casos (n=652) apresentaram idade mediana de 5 anos; 57,1% eram do sexo masculino e 52,0% de raça/cor da pele parda; 6,4% evoluíram a óbito. A chance de óbito foi significativamente maior nos que apresentaram saturação de O2<95% (ORa=4,35 – IC95% 1,69;11,20) e resultado alterado de ureia (ORa=5,18 – IC95% 1,91;14,04); e menor na ausência de manchas vermelhas pelo corpo (ORa=0,23 – IC95% 0,09;0,62), com uso de anticoagulantes (ORa=0,32 – IC95% 0,12;0,89) e imunoglobulinas (ORa=0,38 – IC95% 0,15;1,01). Conclusão: A letalidade foi maior entre casos que apresentaram saturação de O2<95% e ureia alterada; e menor nos que apresentaram manchas vermelhas, usaram imunoglobulinas e anticoagulantes.

Resumo Objetivo Caracterizar o perfil clínico-epidemiológico da síndrome inflamatória multissistêmica pediátrica temporalmente associada à COVID-19 (SIM-P) e identificar fatores associados aos óbitos de SIM-P no Brasil, 2020. Métodos Estudo seccional, utilizando dados do monitoramento nacional da SIM-P. Empregou-se regressão logística para estimar razões de chances (OR, odds ratios ) brutas e ajustadas. Resultados Os casos (n=652) apresentaram mediana de idade de 5 anos; 57,1% eram do sexo masculino e 52,0% de raça/cor da pele parda; 6,4% evoluíram a óbito. A chance de óbito foi significativamente maior nos que apresentaram saturação de O2<95% (ORa=4,35 – IC95% 1,69;11,20) e resultado alterado de ureia (ORa=5,18 – IC95% 1,91;14,04); e menor na ausência de manchas vermelhas pelo corpo (ORa=0,23 – IC95% 0,09;0,62), com uso de anticoagulantes (ORa=0,32 – IC95% 0,12;0,89) e imunoglobulinas (ORa=0,38 – IC95% 0,15;1,01). Conclusão A letalidade foi maior entre casos que apresentaram saturação de O2<95% e ureia alterada; e menor nos que apresentaram manchas vermelhas, usaram imunoglobulinas e anticoagulantes.

Abstract Objective To characterize the clinical-epidemiological profile of multisystem inflammatory syndrome in children temporally associated with COVID-19 (MIS-C), and to identify factors associated with MIS-C deaths in Brazil, 2020. Methods This was a cross-sectional study, using national MIS-C monitoring data. Logistical regression was performed to estimate crude and adjusted odds ratios (OR). Results Median case (n=652) age was 5 years, 57.1% were male, 52.0% were of brown race/skin color and 6.4% died. Likelihood of death was greater among those who presented O2 saturation <95% (ORa=4.35 – 95%CI 1.69;11.20) and altered urea results (ORa=5.18 – 95%CI 1.91;14.04); likelihood of death was lower when red skin blotches were not present (ORa=0.23 – 95%CI 0.09;0.62), when anticoagulants were used (ORa=0.32 – 95%CI 0.12;0.89) and when immunoglobulins were used (ORa=0.38 – 95%CI 0.15;1.01). Conclusion Fatality ratios were higher among cases that presented O2 saturation <95% and altered urea results. Fatality ratios were lower among those with red skin blotches, and those who used immunoglobulins and anticoagulants.

Resumen Objetivo Caracterizar el perfil clínico-epidemiológico de los casos por síndrome inflamatorio multisistémico pediátrico asociado temporalmente a la COVID-19 (SIM-PedS) e identificar factores asociados a los óbitos por SIM-PedS en Brasil, 2020. Métodos Estudio transversal basado en datos del monitoreo nacional de la SIM-PedS, Brasil, 2020. Se utilizó regresión logística para estimar razones de probabilidades brutas y ajustadas (OR, odds ratio). Resultados Los casos (n=652) presentaron edad mediana de 5 años, 57,1% eran hombres, 52,0% de raza/color pardo y 6,4% falleció. La probabilidad de muerte fue significativamente mayor entre aquellos con saturación de O2<95% (ORa=4,35 – IC95%1,69;11,20) y resultado alterado de urea (ORa=5,18 – IC95% 1,91;14,04); menor en ausencia de manchas rojas como erupción (ORa=0,23 – IC95% 0,09;0,62), con uso de anticoagulantes (ORa=0,32 – IC95% 0,12;0,89) e inmunoglobulinas (ORa=0,38 – IC95%0,15;1,01). Conclusión La letalidad fue mayor entre casos que presentaron saturación de O2<95% y urea alterada, y menor entre aquellos con manchas rojas, que usaron inmunoglobulinas y anticoagulantes.

Resumo Objetivo Caracterizar o perfil clínico-epidemiológico da síndrome inflamatória multissistêmica pediátrica temporalmente associada à COVID-19 (SIM-P) e identificar fatores associados aos óbitos de SIM-P no Brasil, 2020. Métodos Estudo seccional, utilizando dados do monitoramento nacional da SIM-P. Empregou-se regressão logística para estimar razões de chances (OR, odds ratios ) brutas e ajustadas. Resultados Os casos (n=652) apresentaram mediana de idade de 5 anos; 57,1% eram do sexo masculino e 52,0% de raça/cor da pele parda; 6,4% evoluíram a óbito. A chance de óbito foi significativamente maior nos que apresentaram saturação de O2<95% (ORa=4,35 – IC95% 1,69;11,20) e resultado alterado de ureia (ORa=5,18 – IC95% 1,91;14,04); e menor na ausência de manchas vermelhas pelo corpo (ORa=0,23 – IC95% 0,09;0,62), com uso de anticoagulantes (ORa=0,32 – IC95% 0,12;0,89) e imunoglobulinas (ORa=0,38 – IC95% 0,15;1,01). Conclusão A letalidade foi maior entre casos que apresentaram saturação de O2<95% e ureia alterada; e menor nos que apresentaram manchas vermelhas, usaram imunoglobulinas e anticoagulantes.

Abstract Objective To characterize the clinical-epidemiological profile of multisystem inflammatory syndrome in children temporally associated with COVID-19 (MIS-C), and to identify factors associated with MIS-C deaths in Brazil, 2020. Methods This was a cross-sectional study, using national MIS-C monitoring data. Logistical regression was performed to estimate crude and adjusted odds ratios (OR). Results Median case (n=652) age was 5 years, 57.1% were male, 52.0% were of brown race/skin color and 6.4% died. Likelihood of death was greater among those who presented O2 saturation <95% (ORa=4.35 – 95%CI 1.69;11.20) and altered urea results (ORa=5.18 – 95%CI 1.91;14.04); likelihood of death was lower when red skin blotches were not present (ORa=0.23 – 95%CI 0.09;0.62), when anticoagulants were used (ORa=0.32 – 95%CI 0.12;0.89) and when immunoglobulins were used (ORa=0.38 – 95%CI 0.15;1.01). Conclusion Fatality ratios were higher among cases that presented O2 saturation <95% and altered urea results. Fatality ratios were lower among those with red skin blotches, and those who used immunoglobulins and anticoagulants.

Resumen Objetivo Caracterizar el perfil clínico-epidemiológico de los casos por síndrome inflamatorio multisistémico pediátrico asociado temporalmente a la COVID-19 (SIM-PedS) e identificar factores asociados a los óbitos por SIM-PedS en Brasil, 2020. Métodos Estudio transversal basado en datos del monitoreo nacional de la SIM-PedS, Brasil, 2020. Se utilizó regresión logística para estimar razones de probabilidades brutas y ajustadas (OR, odds ratio). Resultados Los casos (n=652) presentaron edad mediana de 5 años, 57,1% eran hombres, 52,0% de raza/color pardo y 6,4% falleció. La probabilidad de muerte fue significativamente mayor entre aquellos con saturación de O2<95% (ORa=4,35 – IC95%1,69;11,20) y resultado alterado de urea (ORa=5,18 – IC95% 1,91;14,04); menor en ausencia de manchas rojas como erupción (ORa=0,23 – IC95% 0,09;0,62), con uso de anticoagulantes (ORa=0,32 – IC95% 0,12;0,89) e inmunoglobulinas (ORa=0,38 – IC95%0,15;1,01). Conclusión La letalidad fue mayor entre casos que presentaron saturación de O2<95% y urea alterada, y menor entre aquellos con manchas rojas, que usaron inmunoglobulinas y anticoagulantes.

ABSTRACT Introduction: Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease. Objective: To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period. Methods: A retrospective date analysis was performed from January 2003 to December 2014. The survey was divided in two periods of six years long each, to check for any improvement in the results. We evaluated the numbers of procedures performed, complexity of surgery and hospital mortality. Results: Three thousand and two hundred and one surgeries were performed. Of these, 3071 were able to be classified according to the score RACHS-1. Among the patients, 51.7% were male and 47.5% were younger than one year of age. The most common RACHS-1 category was 3 (35.5%). The mortality was 1.8%, 5.5%, 14.9%, 32.5% and 68.6% for category 1, 2, 3, 4 and 6, respectively. There was a significant increase in the number of surgeries (48%) and a significant reduction in the mortality in the last period analysed (13.3% in period I and 10.4% in period II; P=0.014). Conclusion: RACHS-1 score was a useful score for mortality risk in our service, although we are aware that other factors have an impact on the total mortality.