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Rapid review of multisystem inflammatory syndrome in paediatrics: What we know one year later
Megan Striha1, Rojiemiahd Edjoc1, Natalie Bresee2
1Health Security and Regional Operations Branch, Public Health Agency of Canada, Ottawa, ON.
Insights
Multisystem inflammatory syndrome in children (MIS-C) affects children of all ages, with a significant proportion requiring intensive care and mechanical ventilation. This COVID-19-related condition has a 0%-2% fatality rate, and further research into risk factors is needed.
Area of Science:
- Pediatric infectious diseases
- Public health
- Epidemiology
Background:
- Multisystem inflammatory syndrome in children (MIS-C), also known as PIMS-TS, emerged during the COVID-19 pandemic.
- MIS-C shares features with Kawasaki Disease and toxic shock syndrome, with various definitions established.
- The condition is a significant pediatric concern linked to SARS-CoV-2 infection.
Purpose of the Study:
- To review the epidemiology of MIS-C.
- To identify and synthesize existing literature on MIS-C cases.
- To understand the characteristics and outcomes of MIS-C.
Main Methods:
- A literature review was conducted.
- Searched a Public Health Agency of Canada database for COVID-19 literature.
- Included articles published up to March 9, 2021, referencing MIS-C, PIMS, or Kawasaki Disease in relation to COVID-19.
Main Results:
- 195 articles were included from 988 initially identified.
- Median patient age was 7-10 years, affecting all ages, disproportionately males (58%), Black, and Hispanic children.
- 62% of patients needed ICU admission, 20% required mechanical ventilation, and 0%-2% of cases were fatal.
Conclusions:
- MIS-C affects children of all ages, with a notable need for intensive care and mechanical ventilation.
- Fatality rates ranged from 0% to 2%, varying by population and interventions.
- Further research is required to understand the influence of race, ethnicity, and comorbidities on MIS-C development.
Background:
: Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) is an emerging condition that was first identified in paediatrics at the onset of the COVID-19 pandemic. The condition is also known as pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS or PIMS), and multiple definitions have been established for this condition that share overlapping features with Kawasaki Disease and toxic shock syndrome.
Methods:
: A review was conducted to identify literature describing the epidemiology of MIS-C, published up until March 9, 2021. A database established at the Public Health Agency of Canada with COVID-19 literature was searched for articles referencing MIS-C, PIMS or Kawasaki Disease in relation to COVID-19.
Results:
: A total of 195 out of 988 articles were included in the review. The median age of MIS-C patients was between seven and 10 years of age, although children of all ages (and adults) can be affected. Multisystem inflammatory syndrome in children disproportionately affected males (58% patients), and Black and Hispanic children seem to be at an elevated risk for developing MIS-C. Roughly 62% of MIS-C patients required admission to an intensive care unit, with one in five patients requiring mechanical ventilation. Between 0% and 2% of MIS-C patients died, depending on the population and available interventions.
Conclusion:
: Multisystem inflammatory syndrome in children can affect children of all ages. A significant proportion of patients required intensive care unit and mechanical ventilation and 0%-2% of cases resulted in fatalities. More evidence is needed on the role of race, ethnicity and comorbidities in the development of MIS-C.
