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

Debjyoti Dhar1, Treshita Dey2, M M Samim3

  • 1Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.

Pediatric Research
|May 19, 2021
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 presents with gastrointestinal, cardiac, and neurological symptoms. Early diagnosis and treatment are crucial for favorable outcomes in pediatric MIS-C cases.

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.
Abstract

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