Multisystem inflammatory syndrome in children: A systematic review. (September 2020)

• Record Type: Journal Article
• Authors: Ahmed, Mubbasheer; Advani, Shailesh; Moreira, Axel; Zoretic, Sarah; Martinez, John; Chorath, Kevin; Acosta, Sebastian; Naqvi, Rija; Burmeister-Morton, Finn; Burmeister, Fiona; Tarriela, Aina; Petershack, Matthew; Evans, Mary; Hoang, Ansel; Rajasekaran, Karthik; Ahuja, Sunil; Moreira, Alvaro
• Is Part Of: EClinicalMedicine. Volume 26(2020)
• Publication Date: 2020-09
• Subjects: MIS-C -- PIMS -- COVID-19 -- SARS-CoV-2 -- Multisystem inflammatory syndrome in children -- Coronavirus disease 2019 -- Pediatric inflammatory multisystem syndrome -- Severe acute respiratory syndrome 2 -- Hyperinflammatory shock -- Children -- Pediatric; Medicine -- Research -- Periodicals; Medical policy -- Periodicals; Clinical Medicine; Health Policy; Public Health; Medical policy; Medicine -- Research; Periodical; Electronic journals; Periodicals; 613
• DOI: 10.1016/j.eclinm.2020.100527
• Languages: English
• ISSNs: 2589-5370

Abstract

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