Neurologic and Psychological Outcomes 2 Years After Multisystem Inflammatory Syndrome in Children
Bibliographic record
Abstract
Importance: Neurologic and psychological sequelae are observed 1 year after hospitalization for multisystem inflammatory syndrome in children (MIS-C), but whether these concerns persist is not known. Objective: To examine the trajectory of neurologic, psychological, and quality-of-life sequelae up to 2 years after MIS-C. Design, Setting, and Participants: This longitudinal cohort study assessed children diagnosed with MIS-C from August 1, 2020, to August 31, 2021, and matched sibling and community controls, when available. The study was conducted 6 to 12 months and 18 to 24 months after discharge from a US or Canadian hospital. Data analysis was performed from May 2024 to January 2025. Exposure: Hospitalization for MIS-C. Main Outcomes and Measures: A central study site remotely administered a structured interview, surveys, neuropsychological assessment, and neurologic examination. Group differences were assessed using generalized estimating equations, accounting for matching. Variables extracted from hospital records included intensive care unit admission and echocardiographic left ventricular ejection fraction (LVEF). Results: Overall, 95 participants were included in the study; 93 of 108 participants (86%) returned from the year 1 study and 2 participants were added in year 2 (median [IQR] age, 12.6 [11.0-15.7] years; 38 [40%] female and 57 [60%] male). Fifty-nine patients with MIS-C (mean [SD] age, 13.2 [4.0] years; 39 [66%] male) and 36 controls (mean [SD] age, 13.5 [3.5] years; 18 [50%] male) enrolled. In year 2, the MIS-C group was similar to controls on all outcome measures, except they had more somatization symptoms (Behavior Assessment Scale for Children, Third Edition mean [SD] somatization score, 52.1 [13.0] vs 46.5 [8.5]; mean difference, 5.2; 95% CI, 1.3-9.1). Within the MIS-C group, scores generally improved between initial and follow-up evaluations, a finding that was not observed in controls. Eight of 13 children with MIS-C (62%) who had abnormal neurologic examination findings in year 1 had normal examination findings by year 2. Among patients with MIS-C, measures of higher illness severity during hospitalization were associated with worse executive function in year 2 (National Institutes of Health [NIH] List Sort Working Memory Test score, -7.3 points per intensive care unit admission vs not [95% CI, -14.3 to -0.3 points] and -5.8 points per LVEF category change [95% CI, -9.1 to -2.6 points]; verbal fluency switching score, -0.8 points per LVEF category change [95% CI, -1.5 to -0.1 points]). Conclusions and Relevance: In this longitudinal, matched cohort study of children with MIS-C and controls followed up sequentially up to 2 years after hospital discharge, children with MIS-C had more somatic symptoms than control children. Overall, however, patients with MIS-C had improved neurologic and psychological outcomes between the testing intervals, performing similarly to controls on most measures by year 2 follow-up. These findings suggest that these concerns may improve over time.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".