Multisystem Inflammatory Syndrome in Children Associated With New Coronavirus Infection (Covid-19): Clinical and Morphological Comparisons

Abstract

Multisystem Inflammatory Syndrome in Children (MIS-C) associated with new coronavirus infection (COVID-19), with signs of Kawasaki disease (KD) and toxic shock syndrome, well-defined diagnostic criteria, is the most severe manifestation of COVID-19 in pediatric patients. MIS-C is analogous to the cytokine storm in children with COVID-19. The article presents a clinical observation of a child with MIS-C with a lethal outcome. Clinical and anamnestic data, the results of laboratory and instrumental research allowed to diagnose MIS-C in a 2-year-old girl with full KD form. Autopsy results, detailed microscopic examination, which revealed systemic vasculitis of small and mediumsized vessels, inflammatory infiltrates in different organs, are presented, clinical and morphological comparisons are made.

Heart Involvement in Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children: The Retrospective Multicenter Cohort Data

“…Another publication describes pathomorphological signs of myocarditis (with cellular infiltration and necrosis of cardiomyocytes) and coronaritis in the 2-year-old child with IgM and IgG antibodies to SARS-CoV-2 who died of MIS-C 4 weeks after family contact. In this case, the autopsy revealed histopathological signs of the hemophagocytic syndrome ( 41 ).…”

Histopathological findings of pericarditis in a patient with multisystem inflammatory syndrome in children associated with COVID‐19: A case report

“…There have been a few case reports on the histology of myocarditis in MIS-C patients; however, there have not been any reports about pericarditis in such patients. 10,11 CD8 + T cell infiltration has been predominant in adult COVID-19-associated pericarditis. 12 We observed various inflammatory cell infiltration, including CD8 + or CD4 + T cells, macrophages and granulocytes but not CD20 + B cells, in the pericardium of a child with MIS-C, although SARS-CoV-2 could not be detected in the pericardial tissue by RT-PCR or immunostaining.…”

“…It was found that in MIS‐C the number of inflammatory cells and inflammatory cytokine production were increased in the peripheral blood; 9 however, few findings from tissue specimens have been reported. There have been a few case reports on the histology of myocarditis in MIS‐C patients; however, there have not been any reports about pericarditis in such patients 10,11 . CD8 + T cell infiltration has been predominant in adult COVID‐19‐associated pericarditis 12 .…”

120 years of Morozov Children’s City Clinical Hospital: clinic, science, education

“…В период с 17 мая 2020 г. по 22 июня 2021 г. в МДГКБ были госпитализированы 214 детей с детским мультисистемным воспалительным синдромом, ассоциированным с COVID-19. Эффективность терапии, включая применение экстракорпоральной мембранной оксигенации, была достигнута у 213 больных, у одной из первых пациенток заболевание закончилось летальным исходом [56][57][58]. Сотрудники больницы явились авторами клинических рекомендаций по COVID-19 у детей [59].…”