Clinical characteristics and treatments of multi-system inflammatory syndrome in children: a systematic review

Lee, Keum Hwa and Li, Han and Lee, Min Ho and Park, Se Jin and Kim, Jae Seok and Han, Young Joo and Cho, Kwangwon and Ha, Byeonggwan and Kim, Sung Jun and Jacob, Louis and Koyanagi, Ai and Kim, Ji Hong and Smith, Lee (2022) Clinical characteristics and treatments of multi-system inflammatory syndrome in children: a systematic review. European Review for Medical and Pharmacological Sciences, 26 (9). pp. 3342-3350. ISSN 2284-0729

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Official URL: http://dx.doi.org/10.26355/eurrev_202205_28754

Abstract

OBJECTIVE: Multisystem inflammatory syndrome in children (MIS-C) can occur in association with coronavirus disease 2019 (COVID-19). It is not easy to differentiate MIS-C from severe COVID-19 or Kawasaki disease based on symptoms. The aim of this study was to describe the clinical and laboratory characteristics of MIS-C. PATIENTS AND METHODS: We searched PubMed/Medline for case series and reports of MIS-C published until June 20, 2020. From a total of nine articles involving 45 cases, various clinical and laboratory data were extracted. Each target case was evaluated by using different diagnostic criteria. RESULTS: The average age at onset of MIS-C was 8.6 years. In 80% of cases, the age of patients ranged from 5 to 15 years. Fever (100%) and shock (82%) were the most common presenting symptoms. Sixty percent of cases met the diagnostic criteria for typical or atypical Kawasaki disease. Biomarkers indicative of inflammation, coagulopathy, or cardiac injury were characteristically elevated as follows: ferritin (mean: 1,061 ng/mL), CRP (217 mg/L), ESR (69 mm/hr), IL-6 (214.8 pg/mL), TNFα (63.4 pg/mL), D-dimer (3,220 ng/mL), PT (15.5 s), troponin I (1,006 ng/L), and BNP (12,150 pg/mL). Intravenous immunoglobulin was administered in all target cases, and inotropic agents were commonly used as well. No case of death was observed. CONCLUSIONS: This study demonstrated that MIS-C is a serious condition that presents with fever, rash, as well as cardiovascular and gastrointestinal symptoms. Although it is challenging to differentiate MIS-C from Kawasaki disease or severe COVID-19, initiation of appropriate treatments through early diagnosis is warranted.

Item Type: Journal Article
Keywords: multisystem inflammatory syndrome in children, Kawasaki disease, COVID-19
Faculty: COVID-19 Research Collection
Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 20 Dec 2021 15:26
Last Modified: 17 May 2022 15:19
URI: https://arro.anglia.ac.uk/id/eprint/707201

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