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The multisystem inflammatory syndrome in children and its association to SARS-CoV-2

Florian Piekarski1, Andrea U Steinbicker2, Jakob P Armann3

  • 1Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt.

Current Opinion in Anaesthesiology
|May 30, 2021
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to SARS-CoV-2. While rare, prompt treatment with immunoglobulins, steroids, and biologics leads to recovery with low mortality.

Area of Science:

  • Pediatric infectious diseases
  • Critical care medicine
  • Immunology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome (PIMS), is a novel and severe condition.
  • It is temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Purpose of the Study:

  • To describe the clinical presentation, diagnosis, and treatment recommendations for MIS-C/PIMS.
  • To provide an overview of current literature and expert recommendations.

Main Methods:

  • Review of observational studies, case reports, and expert opinions.
  • Inclusion of current results from the German Registry for PIMS.
  • Development of expert recommendations for treatment.

Main Results:

  • No randomized prospective studies are currently available.
  • MIS-C/PIMS presents with fever, hyper-inflammation, and multi-organ dysfunction, particularly cardiac issues and shock.
  • A significant proportion of affected children require intensive care, though the overall incidence is low.

Conclusions:

  • MIS-C/PIMS is a syndrome associated with various viral infections, including SARS-CoV-2.
  • Treatment involves immunoglobulins, steroids, and biologics, leading to effective outcomes and very low mortality.
  • Most patients recover within days, with sequelae reported in a minority.
Abstract

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