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COVID-19 associated Multisystem Inflammatory Syndrome in Children (MIS-C) guidelines; revisiting the Western New York

Teresa R Hennon1,2, Karl O A Yu1,2, Michelle D Penque1,2

  • 1Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States of America.

Progress in Pediatric Cardiology
|June 14, 2021
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) is a serious concern after SARS-CoV-2 infection. Early screening and multidisciplinary care are vital for better outcomes, especially as cases become sporadic.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) remains a significant concern following SARS-CoV-2 infection.
  • Decreasing SARS-CoV-2 circulation due to vaccination and natural immunity may lead to sporadic MIS-C cases, complicating diagnosis.
  • Children with fever, cardiac dysfunction, Kawasaki disease-like symptoms, or GI complaints require thorough MIS-C screening.

Discussion:

  • An elevated index of suspicion is crucial for timely MIS-C diagnosis.
  • Prompt evaluation in emergency departments, urgent care, and outpatient settings is recommended.
  • Consideration for transfer to pediatric tertiary care or intensive care is advised for severe cases.

Key Insights:

  • Early identification of MIS-C is critical for effective management.
  • Overlap in symptoms with Kawasaki disease necessitates a broad differential diagnosis.
  • Multidisciplinary team involvement is essential for optimal patient outcomes.

Outlook:

  • Developing a standardized, multidisciplinary approach to MIS-C care is paramount.
  • Continued vigilance is needed to manage MIS-C cases effectively.
  • Research into long-term outcomes and management strategies for MIS-C is ongoing.

Keywords:
AP, approvedASO, anti-streptolysin OBNP, brain-natriuretic peptideCDC, Center for Disease ControlCOVID-19COVID-19, coronavirus disease 2019CRP, C-reactive proteinCXCL10, C-X-C-motif chemokine ligand 10DCBLD2, Discoidin, CUB and LCCL domain-containing protein 2E, envelope proteinE.U., European UnionECMO, extracorporeal membrane oxygenationEKG, electrocardiogramEM, emergency useFDA, US Food and Drug AuthorityFeverGI, gastrointestinalIL, interleukinIVIG, intravenous immunoglobulin GInflammationKD, Kawasaki diseaseLDH, lactate dehydrogenaseLFTs, liver function testsM, membrane proteinMIS-CMIS-C, Multisystem Inflammatory Syndrome in ChildrenMpred, methylprednisoloneNP, NucleoproteinPCR, polymerase chain reactionPT, prothrombin timePTT, partial thromboplastin timePediatricRBD, receptor binding domainSARS-CoV-2TE, thromboembolic eventsTNF, tumor necrosis factorTWEAK, TNF-like weak inducer of apoptosisU.S., United States of AmericaVA, veno-arterialVLPs, virus-like particlesVTE, venous thromboembolic events

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