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Multisystem inflammatory syndrome in children (MISC): A systematic review
Daniela Guimarães1, Rita Pissarra2, Ana Reis-Melo1,3
1Faculty of Medicine, University of Porto, Porto, Portugal.
International Journal of Clinical Practice
|June 9, 2021
Summary
Multisystem inflammatory syndrome in children (MISC) often presents with gastrointestinal issues and rash, frequently involving the heart. While intensive care is common, short-term outcomes for MISC are generally favorable with good cardiac recovery.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Multisystem inflammatory syndrome in children (MISC) emerged as a significant concern during the COVID-19 pandemic.
- Understanding the clinical spectrum and management of MISC is crucial for pediatric healthcare providers.
Purpose of the Study:
- To systematically review the literature on multisystem inflammatory syndrome in children (MISC).
- To analyze the clinical spectrum, complications, therapeutic strategies, and differential diagnoses of MISC.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Scopus, Web of Science) from December 2019 to December 2020.
- Systematic screening of titles, abstracts, and full texts was performed independently by two reviewers.
- Data extraction focused on MISC definition, demographics, clinical features, diagnostics, treatments, and outcomes.
Main Results:
- Common symptoms included gastrointestinal (70%), rash (57%), and cardiovascular involvement (52% with shock).
- Notable differences were observed compared to Kawasaki disease in age, presentation, and cardiac involvement.
- SARS-CoV-2 infection was confirmed in 30% (PCR) and 51% (serology); 62% received IVIG, 42% received glucocorticoids; 62% required ICU care, with a mortality rate of <2%.
Conclusions:
- MISC presents a significant risk of severe cardiac involvement at diagnosis, often necessitating intensive care and immunomodulatory therapy.
- Short-term outcomes for MISC appear favorable, with observed recovery of cardiac dysfunction and low mortality rates.
