Updated Management Protocol for Multisystem Inflammatory Syndrome in Children (MIS-C)
Lalit Takia1, Suresh Kumar Angurana1, Karthi Nallasamy1
1Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre (APC), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.
Insights
Multisystem inflammatory syndrome in children (MIS-C) is a serious post-COVID-19 condition. This study proposes a uniform management protocol for MIS-C to improve identification and treatment of this hyper-inflammatory syndrome in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious post-infectious complication of SARS-CoV-2.
- MIS-C commonly affects older children presenting with fever, multi-systemic involvement, and hyper-inflammation.
- Current MIS-C treatment protocols lack global uniformity, particularly in India.
Purpose of the Study:
- To propose a uniform management protocol for MIS-C.
- To enhance early identification and diagnosis of MIS-C in children.
- To stratify treatment based on disease severity and manage hyper-inflammation.
Main Methods:
- Review of existing evidence and recent guidelines on MIS-C management.
- Incorporation of clinical experience from treating MIS-C cases.
- Development of a standardized protocol for identification, diagnosis, and treatment stratification.
Main Results:
- The proposed protocol aims for high sensitivity in identifying MIS-C.
- It facilitates differentiation from other infectious or inflammatory conditions.
- It provides a framework for severity-based management of hyper-inflammatory syndrome.
Conclusions:
- A uniform management protocol is crucial for consistent and effective MIS-C care.
- Standardized approaches can improve patient outcomes by ensuring timely and appropriate interventions.
- Further research and guideline adherence are essential for optimal MIS-C management.
Abstract:
The multisystem inflammatory syndrome in children (MIS-C) is a post-viral immunological or hyper-inflammatory complication of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection commonly seen in older children, who commonly present with fever, multi-systemic involvement including myocardial dysfunction and shock, and hyper-inflammation. The treatment of MIS-C is adapted from the treatment of other immunological or hyper-inflammatory conditions and these treatment protocols are not uniform across the globe, and more so, in India. We propose a uniform management protocol for MIS-C based on our experience of treating MIS-C cases, available evidence till now, and recent guidelines. The aims are to identify children with MIS-C with high sensitivity, recognize other infections or inflammatory processes, stratify treatment based on severity, and manage hyper-inflammatory syndrome.
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