Multisystem inflammatory syndrome in children leads to multiple organ failure

Objectives:
Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 has been increasingly recognized. However, the clinical features of MIS-C and the differences from Kawasaki disease remain unknown. Therefore, this review article has been conducted.

What is the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C)?

Study design:
This review article included a total of 27 studies with 917 MIS-C patients.
The mean age was 9.3 [95% CI = 8.4-10.1].
The pooled proportions of Hispanic and Black cases were 34.6% [95% CI = 28.3 to 40.9] and 31.5% [95% CI = 24.8 to 38.1], respectively.

Results and conclusions:   
The investigators found the common manifestations were gastrointestinal symptoms [87.3%, 95% CI = 82.9 to 91.6] and cardiovascular involvement such as myocardial dysfunction [55.3%, 95% CI = 42.4 to 68.2], coronary artery aneurysms [21.7%, 95% CI = 12.8 to 30.1] and shock [65.8%, 95% CI = 51.1 to 80.4], with marked elevated inflammatory and cardiac markers.

The investigators found the majority of patients received intravenous immunoglobulin [81.0%; 95% CI = 75.0 to 86.9], aspirin [67.3%, 95% CI = 48.8 to 85.7] and corticosteroids [63.6%, 95% CI = 53.4 to 73.8] with a variety of anti-inflammatory agents.

The investigators found although myocardial dysfunction improved in 55.1% [95% CI = 33.4 to 76.8] at discharge, the rate of extracorporeal membrane oxygenation use was 6.3% [95% CI = 2.8 to 9.8] and the mortality was 1.9% [95% CI = 1.0 to 2.8].

The investigators concluded that multisystem inflammatory syndrome in children leads to multiple organ failure, including gastrointestinal manifestations, myocardial dysfunction and coronary abnormalities and has distinct features from Kawasaki disease.

Original title:
COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis by Yasuhara J, Watanabe K, […], Kuno T.

Link:
https://pubmed.ncbi.nlm.nih.gov/33428826/

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