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Multisystem inflammatory syndrome in children and SARS-CoV-2: A scoping review.
J Pediatr Rehabil Med. 2020; 13(3):301-316.JP

Abstract

PURPOSE

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 43 million people resulting in over 1 million deaths. Approximately 2% of cases in the United States are children, and in most cases the child is either asymptomatic or has mild symptoms. However, some pediatric cases can present with Multisystem Inflammatory Syndrome (MIS-C). Understanding the epidemiology, clinical presentation, and management of MIS-C related to SARS-CoV-2 will help to streamline early diagnosis and treatment, particularly in pediatric patients with complex medical conditions.

METHODS

This scoping review adopted methods from the Joanna Briggs Institute (JBI) manual for evidence synthesis and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. Primary studies of patients meeting the Centers for Disease Control and Prevention (CDC) criteria for MIS-C from December 31st, 2019 to Oct 5th, 2020 were identified using PubMed and Scopus. Articles were screened for eligibility, and data collection was conducted on those fulfilling inclusion criteria.

RESULTS

Of 417 studies identified, 57 met inclusion criteria, accounting for 875 patients from 15 countries. Globally, 57% of children affected with MIS-C were males. The median age was 9 years old, ranging from 6 months to 21 years. Forty-five percent of the patients had underlying comorbidities including obesity and lung disease. Fever, conjunctivitis and GI symptoms were common. Most MIS-C patients had high biomarkers including troponin I, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP), D-dimer, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cells (WBCs), interleukin 6 (IL-6), procalcitonin, and ferritin. The treatment for most patients included IVIG and inotropic support.

CONCLUSION

MIS-C can be a unique and potentially life-threatening manifestation of SARS-CoV-2 in children and often requires medical intervention.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33252101

Citation

Panigrahy, Neha, et al. "Multisystem Inflammatory Syndrome in Children and SARS-CoV-2: a Scoping Review." Journal of Pediatric Rehabilitation Medicine, vol. 13, no. 3, 2020, pp. 301-316.
Panigrahy N, Policarpio J, Ramanathan R. Multisystem inflammatory syndrome in children and SARS-CoV-2: A scoping review. J Pediatr Rehabil Med. 2020;13(3):301-316.
Panigrahy, N., Policarpio, J., & Ramanathan, R. (2020). Multisystem inflammatory syndrome in children and SARS-CoV-2: A scoping review. Journal of Pediatric Rehabilitation Medicine, 13(3), 301-316. https://doi.org/10.3233/PRM-200794
Panigrahy N, Policarpio J, Ramanathan R. Multisystem Inflammatory Syndrome in Children and SARS-CoV-2: a Scoping Review. J Pediatr Rehabil Med. 2020;13(3):301-316. PubMed PMID: 33252101.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multisystem inflammatory syndrome in children and SARS-CoV-2: A scoping review. AU - Panigrahy,Neha, AU - Policarpio,Joseph, AU - Ramanathan,Rahul, PY - 2020/11/30/entrez PY - 2020/12/1/pubmed PY - 2020/12/29/medline KW - COVID-19 KW - MIS-C KW - Multisystem inflammatory syndrome in children KW - PIM-TS KW - SARS-CoV-2 KW - coronavirus in children KW - kawasaki disease KW - kawasaki vasculitis KW - kawasaki-like multi-system inflammatory disease KW - multisystem inflammatory syndrome SP - 301 EP - 316 JF - Journal of pediatric rehabilitation medicine JO - J Pediatr Rehabil Med VL - 13 IS - 3 N2 - PURPOSE: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 43 million people resulting in over 1 million deaths. Approximately 2% of cases in the United States are children, and in most cases the child is either asymptomatic or has mild symptoms. However, some pediatric cases can present with Multisystem Inflammatory Syndrome (MIS-C). Understanding the epidemiology, clinical presentation, and management of MIS-C related to SARS-CoV-2 will help to streamline early diagnosis and treatment, particularly in pediatric patients with complex medical conditions. METHODS: This scoping review adopted methods from the Joanna Briggs Institute (JBI) manual for evidence synthesis and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. Primary studies of patients meeting the Centers for Disease Control and Prevention (CDC) criteria for MIS-C from December 31st, 2019 to Oct 5th, 2020 were identified using PubMed and Scopus. Articles were screened for eligibility, and data collection was conducted on those fulfilling inclusion criteria. RESULTS: Of 417 studies identified, 57 met inclusion criteria, accounting for 875 patients from 15 countries. Globally, 57% of children affected with MIS-C were males. The median age was 9 years old, ranging from 6 months to 21 years. Forty-five percent of the patients had underlying comorbidities including obesity and lung disease. Fever, conjunctivitis and GI symptoms were common. Most MIS-C patients had high biomarkers including troponin I, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP), D-dimer, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cells (WBCs), interleukin 6 (IL-6), procalcitonin, and ferritin. The treatment for most patients included IVIG and inotropic support. CONCLUSION: MIS-C can be a unique and potentially life-threatening manifestation of SARS-CoV-2 in children and often requires medical intervention. SN - 1875-8894 UR - https://www.unboundmedicine.com/medline/citation/33252101/Multisystem_inflammatory_syndrome_in_children_and_SARS_CoV_2:_A_scoping_review_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/PRM-200794 DB - PRIME DP - Unbound Medicine ER -