Systemic inflammatory syndrome in COVID-19-SISCoV study: systematic review and meta-analysis

Area of Science:

• Pediatric infectious diseases
• Cardiology
• Neurology

Background:

• An increasing number of Multisystem Inflammatory Syndrome in Children (MIS-C) cases have been reported globally, associated with the SARS-CoV-2 virus.
• This systematic review and meta-analysis examines the demographic, clinical, and prognostic aspects of MIS-C in pediatric populations.

Approach:

• A comprehensive literature search was conducted across multiple databases up to July 10, 2020, adhering to PRISMA guidelines.
• Data from 18 studies involving 833 pediatric patients with MIS-C were pooled for meta-analysis.

Key Points:

• MIS-C predominantly affects males and presents with significant gastrointestinal (84.3%), cardiac (myocarditis 61.8%, left ventricular dysfunction 45.0%), pericardial (31.0%), and neurological (22.9%) symptoms.
• Serological testing for SARS-CoV-2 demonstrated higher sensitivity (65.8%) compared to rtPCR (36.4%). Coronary artery anomalies were noted in 17.2% of cases.
• A low fatality rate of 1.6% was reported, emphasizing the importance of early clinical recognition and intervention.

Conclusions:

• Vigilance for MIS-C symptoms in children with suspected or confirmed SARS-CoV-2 infection is essential for prompt diagnosis.
• Early diagnosis and management are critical for improving patient outcomes and preventing severe complications.
• This review highlights key differences between MIS-C and Kawasaki disease and underscores the limitations of relying solely on rtPCR for MIS-C diagnosis.