Children's Multisystemic Inflammatory Syndrome (MIS-C) associated with SARS-CoV-2 (COVID – 2019): a systematic review
DOI:
https://doi.org/10.52076/eacad-v4i1.422Keywords:
Coronavirus; Inflammation mediators; Childhood onset inflammatory multisystem disease; Pediatrics; Novel coronavirus disease (2019-nCoV).Abstract
Introduction: Children's multisystem inflammatory syndrome (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a dangerous new childhood illness that is temporarily associated with coronavirus disease 2019 (COVID-19). Our aim was to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition. Method: We conducted a systematic review to report the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of subjects with MIS-C. We searched four medical databases to encompass studies featuring 2020 MIS-C. Results: Fever was documented in nearly all patients (99.4%), usually lasting at least 5 days (27.0%). Most (85.6%) had gastrointestinal symptoms, mainly abdominal pain (58.4%), vomiting (57.5%) and diarrhea (50.4%). Cardiovascular manifestations were found in 79.3% of patients (307/387). Tachycardia (194/253; 76.7%), hemodynamic shock or hypotension (416/695; 59.9%), myocarditis (128/309; 41.4%) and mild or moderate decrease in left ventricular ejection fraction (LVEF between 30 and 55%; 40.4%) were frequently observed cardiovascular abnormalities. Discussion: Children typically show signs/symptoms of MIS-C three to four weeks after infection with COVID-19 and many rapidly progress to shock and cardiorespiratory failure. Children will generally survive this hyperinflammatory condition with the administration of IVIG, steroids, a multidisciplinary team of healthcare professionals, and in some cases, immunomodulatory agents. Conclusion: More epidemiological, clinical, immunological and genetic research is needed, as well as long-term follow-up studies of patients with PIMS-TS/MIS(-C).
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Copyright (c) 2023 João Victor Carvalho da Paz; Brunna Renata de Abreu As; Thiara Araújo Fernandes Ribeiro; Lucas Barros Fonseca; Francisco Airton Veras de Araújo Júnior; Tereza Cristina Barbosa Ribeiro do Vale; Bianca Regina Martins Nunes Araújo; Ana Paula Diniz Alves; Alexandre Augusto Gomes Alves; Beatriz da Cruz Alves; Anderson Matheus Medeiros de Araújo; Camila Cristina Coelho Soares Rocio; Kênia Carlos Santana Arrivabene; Francisca Leilisvânia Souza Albuquerque; Camila Melo de Freitas; Kalina Marques Milhomem de Sousa ; Jessica Torres Scherr ; João Victor Araújo Guimarães; Jéssika Fernanda Rocha Santos; Hercules Matheus Melo Duarte; Gilmara Santos Melo Duarte; Ana Maria Neves Sampaio da Luz
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