Multisystem inflammatory syndrome in children: A review

Area of Science:

• Pediatric infectious diseases
• Immunology
• Cardiology

Background:

• Multisystem inflammatory syndrome in children (MIS-C) is a serious condition associated with SARS-CoV-2 infection.
• It presents as a hyperinflammatory syndrome occurring weeks after COVID-19 in susceptible children.
• Clinical manifestations include fever, mucocutaneous and gastrointestinal symptoms, cardiac and lymph node involvement.

Purpose of the Study:

• To provide a comprehensive literature review of MIS-C.
• To summarize current understanding of its epidemiology, pathogenesis, clinical features, and prognosis.
• To identify remaining research questions.

Main Methods:

• Narrative review of studies published from April 2020 to January 2024.
• Synthesis of data on clinical presentation, diagnostic criteria, and treatment strategies.
• Analysis of evolving understanding of MIS-C in the context of the COVID-19 pandemic.

Main Results:

• MIS-C shares features with Kawasaki disease and involves lymphopenia and elevated inflammatory markers.
• New diagnostic criteria have emerged, though epidemiological criteria are becoming less relevant.
• Intravenous immunoglobulin and glucocorticoids are first-line treatments, but the role of biologics requires further study.
• Long-term cardiac monitoring is essential for affected children.

Conclusions:

• MIS-C is a significant post-COVID-19 pediatric inflammatory condition.
• While understanding has advanced, key questions regarding pathogenesis and optimal treatment remain.
• Ongoing research and strict follow-up are vital for managing MIS-C and its long-term effects.