MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN:LONGITUDINAL BODY COMPOSITION ASSESSMENT, INFLAMMATORY MARKERS, AND FATTY ACIDS PROFILE

The Sars-Cov 2 pandemic mainly affected the adult population. However, a small portion of children were affected by Multisystem Inflammatory Syndrome in Children (MIS-C). The severity of the syndrome required patients to be hospitalised and, in some cases, admitted to pediatric intensive care units. A high risk of malnutrition was detected in children hospitalised for long periods. In addition, omega-3 fatty acids (ω-3 FA) were used in conjunction with drug therapy in adults hospitalised for Covid-19 to improve the inflammatory response. The aim of this work was to assess the risk of malnutrition in the acute phase and body composition over time in a cohort of children diagnosed with MIS-C. For all the recruited children, inflammatory markers, metabolic parameters, and fatty acid levels were assessed both in the acute phase and six months after discharge, alongside anthropometric assessment. In half of the patients recruited, three months of docosahexaenoic acid (DHA) supplementation was also recommended. We observed a change in body composition in the acute phase, with a reduction in fat-free mass. In contrast, in the long term we detected a gain in fat mass, probably due to the limited spontaneous and structured physical activity on the part of the children. The fatty acid levels detected in the acute phase were lower than in the healthy population, while the glucose profile was altered. At three and six months after discharge, the ω-3 FA values were higher than the acute phase, particularly in the group that received supplementation. The correlation between ω-3 FA levels and inflammatory indices at six months after discharge in the supplemented group, showed a positive correlation between ω-3 eicosapentaenoic acid (EPA) and erythrocyte sedimentation rate (ESR)and d-dimer, as well as a positive correlation between DHA and ferritin. Overall, the MIS-C children had a favourable disease course. However, nutritional status and loss of body weight should always be monitored in this type of disease during hospitalisation. In the long term, adherence to a balanced diet should be advised along with the resumption of spontaneous and planned physical activity. At the same time, ω-3 FA supplementation may facilitate optimal recovery. As a future perspective, the effectiveness of ω-3 supplementation in the acute phase and later, in seriously ill paediatric patients should be explored.