Multisystem Inflammatory Syndrome Associated With Coronavirus Disease in Children

Abstract

We described the characteristics of 11 children with pediatric multisystem inflammatory syndrome-temporally associated with SARS-CoV-2. The main clinical indications for hospital admission were vasogenic toxic shock (n = 2), Kawasaki disease (n = 4), and Kawasaki disease shock syndrome (n = 5). The echocardiography findings were abnormal in 63% of cases. All patients had 2 or more organ dysfunctions, and the mortality rate was 18%.

The JANUS of chronic inflammatory and autoimmune diseases onset during COVID-19 – A systematic review of the literature

“… [ 213 ] 1 (non-confirmed) F 7 PIMS-TS IVIg, glucocorticoids, ASA Recovered [ 214 ] 3 (2 confirmed) 2 M 1 F 6y PIMS-TS 2 shock IVIg, ASA Recovered [ 215 ] 570 (565 confirmed) 316 M 254 F 8y MIS-C 202 shock 424 IVIg, 331 glucocorticoids, 309 ASA 10 Deaths 95 Coronary artery abnormalities [ 216 ] 30 (2 confirmed) 12 M 2 F 2y 22 complete KD, 8 atypical KD 30 IVIg, 14 IVIg + glucocorticoids, Recovered 2 Coronary artery aneurysms [ 217 ] 25 (17 confirmed) 15 M 10 F 12.5y MIS-C 23 IVIg, 20 glucocorticoids, 10 TCZ, 4 infliximab, 1 anakinra Recovered 7 Coronary artery abnormalities [ 218 ] 11 (all confirmed) 9 M 2 F 59m PIMS-TS, 5 shock N.A. 2 Deaths [ 219 ] 1 (confirmed) M 45y KD IVIg, TCZ, topical glucocorticoids Recovered [ 220 ...…”

Severe COVID-19 Infection and Pediatric Comorbidities: A Systematic Review and Meta-Analysis

“…For details on the underlying conditions represented among all 9, 353 children with comorbidities regardless of COVID-19 severity, see Supplement S3. In the 42 studies included in this meta-analysis, we found that among children with severe COVID-19, 64 children were obese (Abdel-Mannan et al, 2020;Chao et al, 2020;de Farias et al, 2020;DeBiasi et al, 2020;Derespina et al, 2020;Giacomet et al, 2020;Gonzalez-Dambrauskas et al, 2020;Kaushik et al, 2020;Lovinsky-Desir et al, 2020;Shekerdemian et al, 2020;Swann et al, 2020;Waltuch et al, 2020;Zachariah et al, 2020), 58 had chronic respiratory disease (Belhadjer et al, 2020;Chao et al, 2020;DeBiasi et al, 2020;Diorio et al, 2020;Gonzalez-Dambrauskas et al, 2020, Götzinger et al, 2020Lovinsky-Desir et al, 2020;Mannheim et al, 2020;Riollano-Cruz et al, 2020;Shekerdemian et al, 2020;Swann et al, 2020;Waltuch et al, 2020;Yayla et al, 2020;Zachariah et al, 2020), 45 had cardiovascular disease (Chao et al, 2020;DeBiasi et al, 2020;Derespina et al, 2020;Diorio et al, 2020;Eghbali et al, 2020;Garazzino et al, 2020;Giacomet et al, 2020;Gonzalez-Dambrauskas et al, 2020;Götzinger et al, 2020;Kainth et al, 2020;Kaushik et al, 2020;…”

“…Across the 19 articles, of the 274,647 pediatric patients without comorbidities and COVID-19 infection, only 77 (0.03%) died across 8 studies (Bixler et al, 2020;Cai et al, 2020;Du et al, 2020;Götzinger et al, 2020;Leeb et al, 2020;Oualha et al, 2020;Riollano-Cruz et al, 2020;Yayla et al, 2020). In contrast, 134 (1.5%) of the 8960 children with pre-existing conditions died during the course of their SARS-CoV-2 infection across 15 studies (Bellino et al, 2020;Bixler et al, 2020;Blumfield and Levin, 2020;Chao et al, 2020, de Farias et al, 2020Derespina et al, 2020;Diorio et al, 2020;Eghbali et al, 2020;Götzinger et al, 2020;Kainth et al, 2020;Leeb et al, 2020;Moraleda et al, 2020;Otto et al, 2020, Oualha et al, 2020Swann et al, 2020) (Table 1). The random effects model used to determine the risk of mortality among children with comorbidities and COVID-19 relative to pediatric patients without comorbidities revealed a total risk ratio of 2.81 (95% CI 1.31 -6.02; 2 = 97.85 (P < 0.001); I 2 = 82%) ( Figure 4).…”

“…BMI) that can be compared across multiple studies. Although 64 pediatric patients with underlying obesity presented with severe COVID-19 across 13 studies (Abdel-Mannan et al, 2020;Chao et al, 2020;de Farias et al, 2020;DeBiasi et al, 2020;Derespina et al, 2020;Giacomet et al, 2020;Gonzalez-Dambrauskas et al, 2020;Kaushik et al, 2020;Lovinsky-Desir et al, 2020;Shekerdemian et al, 2020;Swann et al, 2020;Waltuch et al, 2020;Zachariah et al, 2020), we chose to perform a meta-analysis only on the studies that included case-control participants (Abdel-Mannan et al, 2020;Chao et al, 2020;Giacomet et al, 2020;Moreno-Galarraga et al, 2020;Swann et al, 2020;Zachariah et al, 2020). Examining the risk of obesity on COVID-19 severity in relation to children without comorbidities and SARS-CoV-2 infection, we obtained a relative risk ratio of 2.87 (95% J o u r n a l P r e -p r o o f CI 1.16 -7.07; 2 = 7.81 (P = 0.17); I 2 = 36%) ( Figure 6).…”

Kawasaki or Kawasaki-like disease? A debate on COVID-19 infection in children

“… All patients had hyponatremia, and lymphocytopenia and thrombocytopenia were present in four and two patients, respectively. de Farias et al (Brazil) [ 8 ] 23 11 6.03 (7 m-11y) 2:9 4 Duration of fever was variable from 4 to 23 days. Abnormal echocardiography (mild and medium aneurysms) was reported in 7 patients.…”