The "perfect" storm: Current evidence on pediatric inflammatory multisystem disease during SARS-CoV-2 pandemic

Area of Science:

• Pediatric infectious diseases
• Pediatric rheumatology
• Critical care medicine

Background:

• COVID-19 predominantly affects adults, with children usually experiencing mild or asymptomatic infections.
• Recent reports highlight a severe inflammatory syndrome in pediatric patients temporally associated with SARS-CoV-2 infection.
• This novel syndrome shares features with Kawasaki disease and other pediatric inflammatory conditions but presents unique characteristics.

Purpose of the Study:

• To summarize current evidence on the clinical features, pathogenesis, therapeutic strategies, and outcomes of this novel pediatric inflammatory syndrome.
• To differentiate this new entity from established pediatric inflammatory syndromes like Kawasaki disease.

Main Methods:

• Systematic review and synthesis of existing case reports and clinical data on pediatric patients with SARS-CoV-2-associated inflammatory syndrome.
• Comparative analysis of clinical characteristics, laboratory findings, and treatment responses.

Main Results:

• The novel syndrome typically affects older children compared to Kawasaki disease.
• Higher frequencies of cardiac involvement and gastrointestinal symptoms are observed.
• Lower frequency of coronary anomalies compared to typical Kawasaki disease.
• Characterized by a cytokine storm with elevated inflammatory markers.

Conclusions:

• A distinct pediatric inflammatory syndrome associated with SARS-CoV-2 has emerged.
• This syndrome presents with unique clinical and epidemiological features, necessitating specific diagnostic and management approaches.
• Further research is crucial to understand the long-term outcomes and optimal treatment strategies.