31 May 2021: EditorialDinah V. Parums *
Med Sci Monit 2021; 27:e933369
ABSTRACT: In early 2020, at the beginning of the coronavirus disease 2019 (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), rare cases were reported in children and adolescents of multisystem inflammatory syndrome in children (MIS-C). MIS-C is characterized by fever, systemic inflammation, and multiorgan dysfunction and usually presents late in SARS-CoV-2 infection. Since May 2020, the Centers for Disease Control and Prevention (CDC) has recorded all reported cases of COVID-19 and MIS-C in children and adolescents in the USA. In April 2021, the American College of Rheumatology (ACR) revised its clinical guidelines for diagnosing and managing hyperinflammation and MIS-C. There are several challenges ahead for preventing, diagnosing, and managing MIS-C, particularly following the rapid emergence of new strains of SARS-CoV-2. This Editorial aims to present an update on the current status of the clinical presentation, diagnosis, and management of MIS-C and includes some updates from population studies and clinical guidelines.
Keywords: Editorial, severe acute respiratory syndrome coronavirus 2, Pediatric Multisystem Inflammatory Disease, COVID-19 Related
MIS-C is a rare acute association with SARS-CoV-2 infection in children. International clinical diagnostic and management guidelines have been developed for MIS-C and are continually updated. The diagnosis of MIS-C is challenging because children can present with non-specific symptoms. Severe MIS-C can present with clinical features similar to toxic shock syndrome, myocarditis, meningitis, sepsis, or systemic vasculitis. However, children who have been in contact with adults with COVID-19 and who present with fever, conjunctivitis, rash, and systemic symptoms should undergo rapid testing for SARS-CoV-2 infection and should be referred to a specialist pediatric infectious diseases unit.
1. Riphagen S, Gomez X, Gonzalez-Martinez C: Hyperinflammatory shock in children during COVID-19 pandemic: Lancet, 2020; 395; 1607-8
2. Godfred-Cato S, Bryant B, Leung J: COVID-19-associated multisystem inflammatory syndrome in children – United States, March–July 2020: Morb Mortal Wkly Rep, 2020; 69(32); 1074-80
3. Verdoni L, Mazza A, Gervasoni A: An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: An observational cohort study: Lancet, 2020; 395; 1771-78
4. Noval Rivas M, Porritt RA, Cheng MH: COVID-19-associated multisystem inflammatory syndrome in children (MIS-C): A novel disease that mimics toxic shock syndrome-the superantigen hypothesis: J Allergy Clin Immunol, 2021; 147(1); 57-59
5. Dufort EM, Koumans EH, Chow EJ: Multisystem inflammatory syndrome in children in New York State: N Engl J Med, 2020; 383; 347-58
6. Kaushik A, Gupta S, Sood M: A systematic review of multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection: Pediatr Infect Dis J, 2020; 39; e340
7. Feldstein LR, Tenforde MW, Friedman KG: Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19: JAMA, 2021; 325; 1074
8. Feldstein LR, Tenforde MW, Friedman KG:: Multisystem inflammatory disease in children (MIS-C), 2021
9. Henderson LA, Canna SW, Friedman KG: American College of Rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: Version 2: Arthritis Rheumatol, 2021; 73(4); e13-29
10. Davies P: Addressing fundamental questions on MIS-C: Lancet Child Adolesc Health, 2021; 5(5); 310-11
11. Abrams JY, Oster ME, Godfred-Cato SE: Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: A retrospective surveillance study: Lancet Child Adolesc Health, 2021; 5(5); 323-31
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