Chest radiograph features of multisystem inflammatory syndrome in children (MIS-C) compared to pediatric COVID-19

Rostad, Bradley S.; Shah, Jay; Rostad, Christina A.; Jaggi, Preeti; Richer, Edward J.; Linam, Leann E.; Alazraki, Adina; Riedesel, Erica L.; Milla, Sarah Sarvis

doi:10.1007/s00247-020-04921-9

Cited by 33 publications

(49 citation statements)

References 15 publications

(22 reference statements)

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“…In an image review of chest radiographs in MIS-C patients, cardiomegaly (63%), cardiogenic pulmonary edema (56%), and atelectasis (56%) were the most common findings [ 50 ]. Other findings on chest radiography in this population included pleural effusions (44–82%), pulmonary consolidations (6–73%), and radiographic findings of acute respiratory distress syndrome (13%) [ 50 , 51 ]. If obtained, abdominal imaging may demonstrate small volume ascites, bowel wall thickening, gallbladder wall thickening, or abdominal lymphadenopathy [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Multisystem inflammatory syndrome in children with COVID-19

Gottlieb

Bridwell

Ravera

et al. 2021

The American Journal of Emergency Medicine

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Background Multisystem inflammatory syndrome in children (MIS-C) is a dangerous pediatric complication of COVID-19. Objective The purpose of this review article is to provide a summary of the diagnosis and management of MIS-C with a focus on management in the acute care setting. Discussion MIS-C is an inflammatory syndrome which can affect nearly any organ system. The most common symptoms are fever and gastrointestinal symptoms, though neurologic and dermatologic findings are also well-described. The diagnosis includes a combination of clinical and laboratory testing. Patients with MIS-C will often have elevated inflammatory markers and may have an abnormal electrocardiogram or echocardiogram. Initial treatment involves resuscitation with careful assessment for cardiac versus vasodilatory shock using point-of-care ultrasound. Treatment should include intravenous immunoglobulin, anticoagulation, and consideration of corticosteroids. Interleukin-1 and/or interleukin-6 blockade may be considered for refractory cases. Aspirin is recommended if there is thrombocytosis or Kawasaki disease-like features on echocardiogram. Patients will generally require admission to an intensive care unit. Conclusion MIS-C is a condition associated with morbidity and mortality that is increasingly recognized as a potential complication in pediatric patients with COVID-19. It is important for emergency clinicians to know how to diagnose and treat this disorder.

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Section: Discussionmentioning

confidence: 99%

Multisystem inflammatory syndrome in children with COVID-19

Gottlieb

Bridwell

Ravera

et al. 2021

The American Journal of Emergency Medicine

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“…While some features of MIS-C, such as fever, conjunctival injection, oropharyngeal erythema, and maculopapular rash, overlap with Kawasaki disease, the two syndromes appear to be separate entities (96,104,107). MIS-C is characterized by various elevated inflammatory laboratory values (erythrocyte sedimentation rate, Creactive protein, procalcitonin, interleukin-6, lactate dehydrogenase, D-dimer, and lymphopenia), myocardial dysfunction (elevated troponins, elevated pro-B-type natriuretic peptide, depressed ejection fraction), hypotension, shock, and acute kidney injury (98,(108)(109)(110)(111)(112). Kawasaki disease has lower rates of myocardial involvement than MIS-C, and is more frequently associated with coronary artery aneurysms.…”

Section: Multisystem Inflammatory Syndrome In the Pediatric Populationmentioning

confidence: 99%

“…(5-70%) of respiratory symptoms has been reported (105,106,108,109,110,112). Although this review is focused on the extra-pulmonary manifestations of COVID-19, the cardiothoracic imaging findings of MIS-C will be included because the majority of MIS-C patients have pulmonary findings that are slightly different than those of routine COVID-19 pneumonia and may have associated cardiac sequelae.…”

Section: Multisystem Inflammatory Syndrome In the Pediatric Populationmentioning

confidence: 99%

“…The most common respiratory complaint in MIS-C is tachypnea, although some patients may progress to respiratory failure requiring mechanical ventilation, likely secondary to shock and cardiac dysfunction (106,108,110,114). While initial chest radiographs can be normal, as the disease progresses, common radiographic J o u r n a l P r e -p r o o f findings include bilateral diffuse airspace opacities with basilar predominance, peribronchial thickening or interstitial opacities, bilateral pleural effusions, and cardiomegaly (112,(114)(115)(116)(117) ( Figure 26,27). The pulmonary opacities tend to be hazy and symmetric, suggesting that they reflect pulmonary edema, ARDS, and/or third spacing.…”

Section: Thoracic Manifestations Of Mis-cmentioning

confidence: 99%

“…The pulmonary opacities tend to be hazy and symmetric, suggesting that they reflect pulmonary edema, ARDS, and/or third spacing. These phenomena may be secondary to cardiac dysfunction, the hyperinflammatory status of the patient, or possibly even the sequelae of aggressive fluid resuscitation (112,(116)(117)(118). Although chest radiograph findings in MIS-C can overlap with acute COVID-19 pneumonia, COVID usually presents as non-diffuse peripheral or subpleural opacities without pleural effusions and MIS-C usually presents as diffuse opacities with lower lobe predominance with pleural effusions (112,117).…”

Section: Thoracic Manifestations Of Mis-cmentioning

confidence: 99%

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Review of COVID-19, part 1: Abdominal manifestations in adults and multisystem inflammatory syndrome in children

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Lung involvement in children with COVID‐19 multisystem inflammatory syndrome

Ghezzi

Longoni

Munari

et al. 2022

Pediatric Pulmonology

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Since the beginning of the COVID‐19 pandemic, multisystem inflammatory syndrome in children (MIS‐C) has been reported in increasing numbers, mostly focusing on cardiac dysfunction. Very few studies have evaluated lung involvement in terms of imaging findings, while data regarding pulmonary function in children with MIS‐C are not available. The purpose of our study was to evaluate lung involvement in MIS‐C by imaging and lung function by structured light plethysmography (SLP) at hospital admission and 6 months afterwards. Spirometry is the gold standard technique to evaluate lung function in children. However, SLP has the advantage of not requiring contact with the patient, offering an effective solution for the evaluation of lung function during the pandemic. To our knowledge this is the first study that aims to investigate pulmonary function by SLP in children with MIS‐C.

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Chest radiograph features of multisystem inflammatory syndrome in children (MIS-C) compared to pediatric COVID-19

Cited by 33 publications

References 15 publications

Multisystem inflammatory syndrome in children with COVID-19

Multisystem inflammatory syndrome in children with COVID-19

Review of COVID-19, part 1: Abdominal manifestations in adults and multisystem inflammatory syndrome in children

Lung involvement in children with COVID‐19 multisystem inflammatory syndrome

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