Pediatric Inflammatory Multisystem Syndrome or Multisystem Inflammatory Syndrome in Children: A New Thread in Pandemic Era

Abstract

After the perturbing effects of the COVID-19 Pandemic, we observed intense public health efforts in a global-scale to prevent, control, and treat the SARS-CoV-2. Hundreds of clinical center researched for adequate treatments, other were devoted to the development the COVID-19 vaccines and other studied the nature and the effects of this mutant coronavirus SARS-CoV-2. As time goes by, the pediatric inflammatory multisystem syndrome has been recently defined and associated the COVID-19 past infection and is now considered a shot to middle-term complication of COVID-19. In this paper, we review the actual concepts of PIMS in children, the epidemiology, the clinical presentation, and evolution, the recommended laboratory and other testing. The recommended specialties interconsultation for hospitalized patients and a full discussion on the appropriate treatment of these patients. We include the Latin-American experience with PIMS and a final discussion on the outcome of this disease.

Adverse Events and Safety Profile of the COVID-19 Vaccines in Adolescents: Safety Monitoring for Adverse Events Using Real-World Data

“…The results of this study support previous findings that myocarditis/pericarditis is the most frequently reported severe AE after COVID-19 vaccination in adolescents [ 21 , 36 , 37 ]. The COVID-19 vaccine or SARS-CoV-2 infection increases the blood viscosity [ 12 , 38 ] and increases the expression levels of angiotensin-converting enzyme 2 [ 29 ]. As a result, underlying cardiac pathologies may be exacerbated, leading to myocarditis or pericarditis [ 12 , 39 ].…”

“…The COVID-19 vaccine or SARS-CoV-2 infection increases the blood viscosity [ 12 , 38 ] and increases the expression levels of angiotensin-converting enzyme 2 [ 29 ]. As a result, underlying cardiac pathologies may be exacerbated, leading to myocarditis or pericarditis [ 12 , 39 ]. In previous studies, myocarditis and pericarditis were more frequent in men than in women [ 23 , 24 , 25 ] after the second dose of the vaccine [ 3 ].…”

“…Although children typically have relatively mild clinical presentations of SARS-CoV-2 infection with few complications [ 8 ], case–fatality rate in children with COVID-19 was reported in 0.3~0.69% [ 9 , 10 ]. Furthermore, multisystem inflammatory syndromes and myocarditis have been rarely reported, and those symptoms are severe [ 11 , 12 ]. In addition, inflammatory disorders such as Kawasaki disease, toxic shock syndrome, secondary hemophagocytic lymphohistiocytosis, and macrophage activation syndrome, have also been reported and are associated with a recent infection with SARS-CoV-2 [ 13 ].…”

Ocular Manifestations of Pediatric Inflammatory Multisystem Syndrome

“…PIMS affects mostly children with no history of chronic illnesses [9,10]. There are many hypotheses explaining the pathogenesis of PIMS.…”

“…The first one is that SARS CoV-2 can block some types of interferon responses leading to delayed cytokine storm. This can happen especially in patients with difficulties in controlling viral replication or with high viral load [9,11]. The second hypothesis says that the IgG antibody-dependent enhancement (ADE) of the disease can lead to the greater activation of monocytes, CD8+ T-cells, and cytopenia [9,[11][12][13].…”