doi.org
Long-Term Outcomes of Multisystem Inflammatory Syndrome in Children up to 4.5 Years After COVID-19
OBJECTIVES. The risk of persistent multisystem dysfunction following multisystem inflammatory syndrome in children (MIS-C), a severe postviral complication of COVID-19, remains unknown.METHODS. We investigated long-term outcomes in patients younger than 21 years with MIS-C (n = 173) vs without MIS-C (n = 14 190) up to 4.5 years after COVID-19 in the Montefiore Health System (March 2020 to August 2024). MIS-C status was based on International Classification of Diseases, Tenth Revision codes and Centers for Disease Control and Prevention and World Health Organization criteria. 1:2 propensity score matching and Cox proportional hazards regression with multivariable adjustment were performed.RESULTS. Compared with patients without, patients with MIS-C showed markedly higher risk of cardiovascular disorders (adjusted hazard ratio [aHR] = 13.88 [4.69–41.07], P < .001), hypertension (aHR = 8.86 [4.12–19.06], P < .001), gastrointestinal disorders (aHR = 9.48 [2.66–33.71], P < .001), respiratory disorders (aHR = 3.46 [2.21–5.42], P < .001), and neurological disorders (aHR = 2.02 [1.22–3.34], P = .007). Preexisting hypertension (9.25% of patients with MIS-C vs 6.94% of controls) significantly predicted cardiovascular, neurological, respiratory, and gastrointestinal outcomes. Each 1-year increase in age was associated with increased risk of shock (aHR = 1.06 [1.02–1.11]) and chronic kidney disease (CKD) (aHR = 1.06 [1.01–1.12]). Preexisting diabetes (1.73% of patients with MIS-C) was associated with a 49-fold increased risk of CKD. Kaplan-Meier analysis showed higher persistent risk in the MIS-C group across all outcomes, ranging from 6.8% for CKD to 35.2% for respiratory disorders. Sensitivity analysis using different definitions of MIS-C corroborated our main findings.CONCLUSIONS. MIS-C is associated with broad multisystem morbidity persisting years after acute COVID-19, challenging earlier reports of transient illness. Structured long-term follow-up, including routine blood pressure monitoring, neurological and mental-health screening, and cardiovascular and renal surveillance, with coordinated multidisciplinary care is warranted.
![A piece of paper on a red table reads “Schiarc’ "skeearch" in Bagnolese Di. lect]
Schiarc' or pizzette fritte [fried bread] in Italian, are small rounds of dough that are deep fried and sprinkled with either sugar, or less commonly, salt, for a savoury version.
Historically they were made with the dough that was left over after the monthly bread baking in communal wood burning ovens, and were considered a special treat! The simple ingredients of whole wheat flour, salt, water, and sourdough starter that were used in traditional bread making throughout Italy, resulted in a rustic, firmer and chewier schiarc'
As sugar was considered a luxury they were more likely to be eaten plain or salted.
With the introduction of commercial white flour and different leavening agents, today Italians enjoy pizzette fritte whenever it suits them. The addition of cinnamon and honey has also become a favourite variation of the classic recipe.
As a popular street food, the Familia Bagnolese Society is proud to serve schiarc' .......and introduce a little bit of our
culture to Vancouver!” There is a small picture of fried dough at the bottom of the page.](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:dgbzrzxof35hgfzss7modgel/bafkreia3ljdpdtxpnxyadrjybo3mkycgc3zxvokr3ysau55xfctho4dfvq)
