Yilmaz D.Ekemen Keles Y.Emiroglu M.Duramaz B.B.Ugur C.Aldemir Kocabas B.Celik T.Ozdemir H.Bayturan S.Turel O.Erdeniz E.H.Cakici O.Cakmak Taskin E.Erbas İ.C.Genceli M.Sari E.E.Caymaz C.Kizil M.C.Sutcu M.Demirbuga A.Alkan G.Bagcı Z.Timurtas Dayar G.Ozkan E.A.Tekin Yilmaz A.Akca M.Yesil E.Kara S.S.Akturk H.Yasar B.Umit Z.Uygun H.Erdem N.Buyukcam A.Karadag Oncel E.Tuter Oz S.K.Cetin H.S.Anil A.B.Yilmaz R.Zengin N.Uzuner S.Albayrak H.Borakay O.Topal S.Arslan G.Yazar A.Ozer A.Kendirli T.Kara E.M.Demirkol D.Battal F.Kosker M.Metin Akcan O.Kihtir H.S.Gul D.Zararci K.Alakaya M.Kula N.Celik E.Petmezci E.Evren G.Kara Aksay A.Konca C.Sert A.Arslan D.Bornaun H.Tekeli O.Bal A.Sahin I.O.Demir S.Sap F.Akyol M.B.Tanidir I.C.Donmez Y.N.Ucar T.Coban S.Arga G.Hancerli Torun S.Karpuz D.Celik S.F.Varan C.Elmali F.Oncel S.Belet N.Hatipoglu N.Dalgic Karabulut N.Turgut M.Somer A.Kuyucu N.Dinleyici E.C.Ciftci E.Kara A.2024-07-222024-07-22202303406199http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11680Purpose: Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU). Methods: This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented. Results: A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5–11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells × μL, platelet count 153 vs. 212 cells × 103/ μL, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 μg/L, ferritin 644 vs. 334 μg/L, all for p< 0.001). Being between ages 5–12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971–8.627] and six times (95% CI 2.575–14.654), respectively, compared to being between the ages 0–5. A one-unit increase in log d-dimer (µg/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079–3.233) and 1.4 times (95% CI 1.133–1.789), respectively. Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care. What is Known: • Lymphopenia and thrombocytopenia were an independent predictor factors in patients with MISC who needed to stay in intensive care unit. • The possibility of the need to stay in the intensive care unit in patients with MISC who had Kawasaki disease-like findings was controversial compared with those who did not. What is New: • A one-unit increase log D dimer and log troponin was demonstrated to require for intensive care unit by 1.8 and 1.4 times, respectively. • Serum procalcitonin levels had the best performance to predict stay in the intensive care unit stay. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.EnglishChildChild, PreschoolFerritinsHumansInfantInfant, NewbornIntensive Care UnitsMucocutaneous Lymph Node Syndromepediatric multisystem inflammatory disease, COVID-19 relatedProcalcitoninRetrospective StudiesTroponinacetylsalicylic acidalanine aminotransferasealbuminamino terminal pro brain natriuretic peptideanakinraanticoagulant agentaspartate aminotransferasebrain natriuretic peptideC reactive proteincorticosteroidcreatinineD dimerferritinimmunoglobulininotropic agentprocalcitoninsodiumtroponinureaferritinprocalcitonintroponinabdominal painalanine aminotransferase levelalbumin blood levelarthralgiaArticleaspartate aminotransferase levelchildchronic diseaseclinical outcomeconjunctivitiscoronary artery aneurysmcoronavirus disease 2019creatinine blood leveldemographicsdermatitisdiarrheadisease durationechocardiographyfatiguefemalefeverfollow upgastrointestinal symptomheadacheheart arrhythmiahospitalizationhumanimmune deficiencyimmunotherapyintensive careinternational normalized ratiolaboratory testlength of staylip fissurelymphadenopathylymphocyte countlymphocytopeniamajor clinical studymalemucocutaneous lymph node syndromemulticenter studymyalgianeutrophil countobesityobservational studypediatric multisystem inflammatory syndromeplatelet countrespiratory tract diseaseretrospective studysensitivity and specificityserologyshocksinus bradycardiasodium blood levelthrombocytopeniatreatment outcomeurea blood levelvomitingclinical trialinfantintensive care unitmucocutaneous lymph node syndromenewbornpreschool childArticle10.1007/s00431-023-05207-6