Multisystem inflammatory syndrome in children: A systematic review
Mubbasheer Ahmed, Shailesh Advani, Axel Moreira, Sarah Zoretic, John Martinez, Kevin Chorath, Sebastián Acosta, Rija Naqvi, Finn Burmeister-Morton, Fiona Burmeister, Aina Tarriela, Matthew Petershack, Mary Evans, Ansel Hoang, Karthik Rajasekaran, Sunil K. Ahuja, Alvaro Moreira
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 . We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition. Methods: We conducted a systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C. We searched four medical databases to encompass studies characterizing MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors screened articles, extracted data, and assessed risk of bias. This review was registered with PROSPERO CRD42020191515. Findings: Our search yielded 39 observational studies (n = 662 patients). While 710% of children (n = 470) were admitted to the intensive care unit, only 11 deaths (17%) were reported. Average length of hospital stay was 79 06 days. Fever (100%, n = 662), abdominal pain or diarrhea (737%, n = 488), and vomiting (683%, n = 452) were the most common clinical presentation. Serum inflammatory, coagulative, and cardiac markers were considerably abnormal. Mechanical ventilation and extracorporeal membrane oxygenation were necessary in 222% (n = 147) and 44% (n = 29) of patients, respectively. An abnormal echocardiograph was observed in 314 of 581 individuals (540%) with depressed ejection fraction (451%, n = 262 of 581) comprising the most common aberrancy. Interpretation: Multisystem inflammatory syndrome is a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown.