Systemic inflammatory syndrome in COVID-19–SISCoV study: systematic review and meta-analysis

Abstract

BACKGROUND: There has been a recent upsurge in the cases of Multisystem inflammatory syndrome in children (MIS-C) associated with Coronavirus disease . We performed a systematic review and meta-analysis on the demographic profile, clinical characteristics, complications, management, and prognosis of this emerging novel entity. METHODS: Using a predefined search strategy incorporating MeSH terms and keywords, all known literature databases were searched up till 10th July 2020. The review was done in accordance with PRISMA guidelines and registered in PROSPERO (CRD4202019757). RESULTS: Of the 862 identified publications, 18 studies comprising 833 patients were included for meta-analysis. The sociodemographic profile showed male predilection (p = 0.0085) with no significant racial predisposition. A higher incidence of gastrointestinal symptoms (603/715, 84.3%), myocarditis (191/309, 61.8%), left ventricular dysfunction (190/422, 45.0%), pericardial (135/436, 31.0%) and neurological symptoms (138/602, 22.9%) was reported. Serological evidence of SARS-CoV-2 had higher sensitivity compared to rtPCR (291/800, 36.4% vs 495/752, 65.8%; p < 0.001). Coronary artery anomaly (CAA) was reported in 117/681 in 9 publications (17.2%). A total of 13 (1.6%) fatalities were reported. CONCLUSION: Clinicians need to be vigilant in identifying the constellation of these symptoms in children with clinical or epidemiologic SARS-CoV-2 infection. Early diagnosis and treatment lead to a favorable outcome.

Multisystem Inflammatory Syndrome in Children: Follow-Up of a Cohort from North India

“… 9 , 17 The mortality of 5% ( N = 2) in this index study is higher than that reported from developed countries. 3 – 8 Both cases died because of refractory shock within 24 hours of admission. This highlights the importance of early identification, resuscitation (with fluids and vasoactive drugs), and targeted immunomodulation upon first contact with the healthcare facility.…”

“… 3 – 7 With supportive treatment and immunomodulation (intravenous immunoglobulin [IVIG] and steroids), the short-term outcome is good and mortality is 0–2%. 3 – 8 Long-term treatment with glucocorticoids, aspirin, or anticoagulants in MIS-C is based on experience with other inflammatory conditions like Kawasaki disease (KD) and the exact duration of treatment is not known. The suggested duration for immunomodulation is 2–3 weeks or even longer with severe disease.…”

Síndrome inflamatória multissistêmica (SIMS) pós-COVID-19

“…3.Alterações de extremidades (eritema palmar ou plantar, edema de mãos e pés, descamação periungueal na fase convalescente). Figura 1 -Mecanismos patogênicos hipotéticos para a SIMS, sumário (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43). SARS-CoV-2, coronavirus 2 da síndrome respiratória aguda grave; SIMS, síndrome inflamatória multisistêmica; Th1, célula T helper 1; Th17, célula T helper 17.…”

The rising appendicitis mimicker: A case report of Multisystem Inflammatory Syndrome in Children presenting with acute abdomen

“… 3 A recent meta-analysis found that gastrointestinal involvement was present in 84.3% of MIS-C cases. 4 In New York State, between 1 March and 10 May 2020, the incidence of MIS-C in those younger than 21 years was 2 per 100,000. 3 We describe an MIS-C patient whose initial presentation resembled appendicitis.…”