tetano
Editor, Senior Moderator
EClinicalMedicine
. 2020 Sep 4;100527.
doi: 10.1016/j.eclinm.2020.100527. Online ahead of print.
Multisystem inflammatory syndrome in children: A systematic review
Mubbasheer Ahmed[SUP] 1 [/SUP], Shailesh Advani[SUP] 2 3 [/SUP], Axel Moreira[SUP] 1 [/SUP], Sarah Zoretic[SUP] 4 [/SUP], John Martinez[SUP] 4 [/SUP], Kevin Chorath[SUP] 5 [/SUP], Sebastian Acosta[SUP] 1 [/SUP], Rija Naqvi[SUP] 1 2 3 4 5 [/SUP], Finn Burmeister-Morton[SUP] 4 [/SUP], Fiona Burmeister[SUP] 4 [/SUP], Aina Tarriela[SUP] 4 [/SUP], Matthew Petershack[SUP] 4 [/SUP], Mary Evans[SUP] 4 [/SUP], Ansel Hoang[SUP] 4 [/SUP], Karthik Rajasekaran[SUP] 5 [/SUP], Sunil Ahuja[SUP] 4 [/SUP], Alvaro Moreira[SUP] 4 [/SUP]
Affiliations
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 (COVID-19). We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition.
Methods: We conducted a systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C. We searched four medical databases to encompass studies characterizing MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors screened articles, extracted data, and assessed risk of bias. This review was registered with PROSPERO CRD42020191515.
Findings: Our search yielded 39 observational studies (n = 662 patients). While 71?0% of children (n = 470) were admitted to the intensive care unit, only 11 deaths (1?7%) were reported. Average length of hospital stay was 7?9 ? 0?6 days. Fever (100%, n = 662), abdominal pain or diarrhea (73?7%, n = 488), and vomiting (68?3%, n = 452) were the most common clinical presentation. Serum inflammatory, coagulative, and cardiac markers were considerably abnormal. Mechanical ventilation and extracorporeal membrane oxygenation were necessary in 22?2% (n = 147) and 4?4% (n = 29) of patients, respectively. An abnormal echocardiograph was observed in 314 of 581 individuals (54?0%) with depressed ejection fraction (45?1%, n = 262 of 581) comprising the most common aberrancy.
Interpretation: Multisystem inflammatory syndrome is a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown.
Funding: Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study.
Keywords: COVID-19; Children; Coronavirus disease 2019; Hyperinflammatory shock; MIS-C; Multisystem inflammatory syndrome in children; PIMS; Pediatric; Pediatric inflammatory multisystem syndrome; SARS-CoV-2; Severe acute respiratory syndrome 2.
. 2020 Sep 4;100527.
doi: 10.1016/j.eclinm.2020.100527. Online ahead of print.
Multisystem inflammatory syndrome in children: A systematic review
Mubbasheer Ahmed[SUP] 1 [/SUP], Shailesh Advani[SUP] 2 3 [/SUP], Axel Moreira[SUP] 1 [/SUP], Sarah Zoretic[SUP] 4 [/SUP], John Martinez[SUP] 4 [/SUP], Kevin Chorath[SUP] 5 [/SUP], Sebastian Acosta[SUP] 1 [/SUP], Rija Naqvi[SUP] 1 2 3 4 5 [/SUP], Finn Burmeister-Morton[SUP] 4 [/SUP], Fiona Burmeister[SUP] 4 [/SUP], Aina Tarriela[SUP] 4 [/SUP], Matthew Petershack[SUP] 4 [/SUP], Mary Evans[SUP] 4 [/SUP], Ansel Hoang[SUP] 4 [/SUP], Karthik Rajasekaran[SUP] 5 [/SUP], Sunil Ahuja[SUP] 4 [/SUP], Alvaro Moreira[SUP] 4 [/SUP]
Affiliations
- PMID: 32923992
- PMCID: PMC7473262
- DOI: 10.1016/j.eclinm.2020.100527
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 (COVID-19). We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition.
Methods: We conducted a systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C. We searched four medical databases to encompass studies characterizing MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors screened articles, extracted data, and assessed risk of bias. This review was registered with PROSPERO CRD42020191515.
Findings: Our search yielded 39 observational studies (n = 662 patients). While 71?0% of children (n = 470) were admitted to the intensive care unit, only 11 deaths (1?7%) were reported. Average length of hospital stay was 7?9 ? 0?6 days. Fever (100%, n = 662), abdominal pain or diarrhea (73?7%, n = 488), and vomiting (68?3%, n = 452) were the most common clinical presentation. Serum inflammatory, coagulative, and cardiac markers were considerably abnormal. Mechanical ventilation and extracorporeal membrane oxygenation were necessary in 22?2% (n = 147) and 4?4% (n = 29) of patients, respectively. An abnormal echocardiograph was observed in 314 of 581 individuals (54?0%) with depressed ejection fraction (45?1%, n = 262 of 581) comprising the most common aberrancy.
Interpretation: Multisystem inflammatory syndrome is a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown.
Funding: Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study.
Keywords: COVID-19; Children; Coronavirus disease 2019; Hyperinflammatory shock; MIS-C; Multisystem inflammatory syndrome in children; PIMS; Pediatric; Pediatric inflammatory multisystem syndrome; SARS-CoV-2; Severe acute respiratory syndrome 2.