The Trilogy of SARS-CoV-2 in Pediatrics (Part 2): Multisystem Inflammatory Syndrome in Children

Area of Science:

• Pediatric critical care medicine
• Pediatric rheumatology
• Infectious diseases

Background:

• Multisystem Inflammatory Syndrome in Children (MIS-C) emerged in 2020.
• It shares features with hyperinflammatory syndromes like Kawasaki disease and macrophage activation syndrome.
• Clinical presentation ranges from mild febrile illness to critical shock.

Purpose of the Study:

• To provide a comprehensive review of published data on MIS-C evaluation and management.
• To focus on pharmacotherapy treatment considerations for MIS-C.
• To address the lack of controlled trials for MIS-C treatment.

Main Methods:

• Systematic review of published literature on MIS-C.
• Analysis of clinical manifestations, diagnostic criteria, and treatment strategies.
• Synthesis of data from case reports, case series, and observational studies.

Main Results:

• Common symptoms include persistent fever and gastrointestinal issues.
• Cardiac involvement, such as ventricular dysfunction and coronary aneurysms, is a significant concern.
• Current treatment relies on immunomodulatory agents, often extrapolated from Kawasaki disease protocols.

Conclusions:

• MIS-C requires prompt recognition and multidisciplinary management.
• Pharmacotherapy for MIS-C is largely empirical, necessitating further research.
• Evidence-based guidelines for MIS-C treatment are needed.