Coronavirus Disease 2019-Related Multisystem Inflammatory Syndrome in Children: A Systematic Review and Meta-Analysis

Abstract

Background. This study aimed to describe the clinical symptoms, laboratory findings, treatment, and outcomes of coronavirus disease 2019-related multisystem inflammatory syndrome in children to provide a reference for clinical practice. Methods. We employed a literature search of databases such as PubMed, Web of Science, EMBASE, and Johns Hopkins University for articles on COVID-19-related multisystem inflammatory syndrome in children published between April 1, 2020, and January 15, 2021. High-quality articles were selected for analysis on the basis of their quality standard scores. Using R3.6.3 software, meta-analyses of random- or fixed-effects models were used to determine the prevalence of comorbidities. Subgroup analysis was also performed to determine heterogeneity. Results. A total of 57 articles (2,290 pediatric patients) were included in the study. Clinical Manifestations. :ncidences of fever, gastrointestinal symptoms, respiratory symptoms, and musculoskeletal symptoms (myalgias or arthralgias) were 99.91% (95% CI: 99.67–100%), 82.72% (95% CI: 78.19–86.81%), 53.02% (45.28–60.68%), and 14.16% (95% CI: 8.4–21.12%), respectively. The incidences of rash, conjunctival injection, lymphadenopathy, dry cracked lips, neurologic symptoms (headache, altered mental status, or confusion), swollen hands and feet, typical Kawasaki disease, and atypical Kawasaki disease were 59.34% (95% CI: 54.73–63.87%), 55.23% (95% CI: 50.22–60.19%), 27.07% (95% CI: 19.87–34.93%), 46.37% (95% CI: 39.97–52.83%), 28.87% (95% CI: 22.76–35.40%), 28.75% (95% CI: 21.46–36.64%), 17.32% (95% CI: 15.44–19.29%), and 36.19% (95% CI: 21.90–51.86%), respectively. The incidences of coronary artery dilation, aneurysm, pericardial effusion, myocarditis, myocardial dysfunction, high troponin, and N-terminal pro-B-type natriuretic peptide were 17.83%, 6.85%, 20.97%, 35.97%, 56.32%, 76.34%, and 86.65%, respectively. The incidences of reduced lymphocytes, thrombocytopenia, hypoalbuminemia, elevated C-reactive protein, ferritin, LDH, interleukin-6, PCT, and FIB were 61.51%, 26.42%, 77.92%, 98.5%, 86.79%, 80.59%, 89.30%, 85.10%, and 87.01%, respectively. PICU Hospitalization Rate and Mortality. The incidences of PICU hospitalization or with shock were 72.79% and 55.68%, respectively. The mortality rate was 1.00%. Conclusion and Relevance. PICU hospitalization and shock rates of multisystem inflammatory syndrome in children associated with COVID-19 were high, and its cumulative multiorgans and inflammatory indicators are increased, but if treated in time, the mortality rate was low.

Factors of parental COVID-19 vaccine hesitancy: A cross sectional study in Japan

“…Although children have been considered to develop mild symptoms compared to adults, recent studies have reported that COVID-19-related multisystem inflammatory syndrome can cause morbidity and mortality [ 34 , 35 ]. The recent rapid increase of cases among children could lead to an increase of severe cases in this age group.…”

Eye and SARS-CoV-2 in 2022

“…Although conjunctivitis itself is largely benign and self-limiting, it can occur in up to 55% of children with COviD-19-related polyarthritis, a more serious condition requiring urgent attention. Therefore, children with conjunctival symptoms should be investigated for other associated symptoms, including rash, lymphadenopathy, and limb edema [17]. Swelling of the eyelids was found in 0.9% of COviD-19 patients, their irritation in 4.9% of individuals, most often in combination with conjunctival congestion [11,[18][19][20].…”

COVID-19 Pneumonia in Vaccinated Population: A Six Clinical and Radiological Case Series

“…The pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its related disease (COVID-19) represents a major challenge for humans. To date, COVID-19 has caused more than 3 million deaths, leading to economic troubles in several countries [ 1 , 2 , 3 , 4 ].…”

“…COVID-19 has a multisystem involvement affecting not only the lungs but also the cardiovascular, nervous, and gastrointestinal systems. In adults, and especially in children, COVID-19 has led to a multisystem inflammatory syndrome [ 1 , 2 , 3 , 4 ].…”