Related Experiment Video
Updated: Dec 9, 2025
Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
Published on: September 7, 2022
A Systematic Review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection
Ashlesha Kaushik1, Sandeep Gupta2, Mangla Sood3
1From the Division of Pediatric Infectious Diseases, UnityPoint Health at St. Luke's Regional Medical Center and Department of Pediatrics, University of Iowa Carver College of Medicine.
Insights
Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 often requires critical care and immunomodulatory treatments. Despite severe symptoms, most children with MIS-C experienced favorable outcomes with low mortality rates.
Area of Science:
- Pediatric critical care
- Infectious diseases
- Systemic inflammatory syndromes
Background:
- Severe COVID-19 manifestations include multisystem inflammatory syndrome in children (MIS-C).
- Understanding MIS-C management is crucial for affected children.
Purpose of the Study:
- To systematically review and summarize the clinical features, management strategies, and outcomes of MIS-C in children.
- To analyze the available literature on MIS-C to inform clinical practice.
Main Methods:
- Systematic literature search of multiple databases and preprint servers (PubMed, EMBASE, CINAHL, BioRxiv, MedRxiv) from January to July 2020.
- Inclusion of observational studies (cross-sectional, cohort, case series, case reports) adhering to PRISMA guidelines.
- Analysis of data from 16 studies involving 655 pediatric patients with MIS-C.
Main Results:
- Most MIS-C patients presented with fever, gastrointestinal issues, and Kawasaki Disease-like symptoms.
- High rates of critical care (68%), inotropes (40%), anticoagulation (34%), and mechanical ventilation (15%) were observed.
- Intravenous immunoglobulin (IVIG) and corticosteroids were common; Remdesivir and convalescent plasma were rare. Left ventricular dysfunction (32%) and coronary abnormalities (23%) were noted.
Conclusions:
- MIS-C is a significant condition requiring intensive care and immunomodulatory therapies.
- The majority of children with MIS-C achieved favorable outcomes, with a low overall mortality rate (1.7%).
- This review highlights key clinical aspects and treatment responses in pediatric MIS-C cases.
Background:
Recently, severe manifestations associated with coronavirus disease 2019 (COVID-19) called multisystem inflammatory syndrome in children (MIS-C) have been recognized. Analysis of studies for this novel syndrome is needed for a better understanding of effective management among affected children.
Methods:
An extensive search strategy was conducted by combining the terms multisystem inflammatory syndrome in children and coronavirus infection or using the term multisystem inflammatory syndrome in children in bibliographic electronic databases (PubMed, EMBASE, and CINAHL) and in preprint servers (BioRxiv.org and MedRxiv.org) following the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines to retrieve all articles published from January 1, 2020, to July 31, 2020. Observational cross-sectional, cohort, case series, and case reports were included.
Results:
A total of 328 articles were identified. Sixteen studies with 655 participants (3 months-20 years of age) were included in the final analysis. Most of the children in reported studies presented with fever, gastrointestinal symptoms, and Kawasaki Disease-like symptoms. Sixty-eight percent of the patients required critical care; 40% needed inotropes; 34% received anticoagulation; and 15% required mechanical ventilation. More than two-thirds of the patients received intravenous immunoglobulin and 49% received corticosteroids. Remdesivir and convalescent plasma were the least commonly utilized therapies. Left ventricular dysfunction was reported in 32% of patients. Among patients presenting with KD-like symptoms, 23% developed coronary abnormalities and 26% had circulatory shock. The majority recovered; 11 (1.7%) children died.
Conclusions:
This systematic review delineates and summarizes clinical features, management, and outcomes of MIS-C associated with SARS-CoV-2 infection. Although most children required intensive care and immunomodulatory therapies, favorable outcomes were reported in the majority with low-mortality rates.
More Related Videos
08:36Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment
Published on: April 19, 2024
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include: