Symptomatology, diagnosis, and treatment of multisystemic inflammatory syndrome in post covid-19 infants: literature review
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Published:
Feb 6, 2023
Keywords:
Multisystemic inflammatory syndrome, COVID-19, symptomatology, diagnosis, children
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Abstract
Introduction. In 2020, COVID-19-associated multisystem inflammatory syndrome in children was first reported, which can have a severe course and may require supportive care. Objective. To review the scientific literature on symptomatology, diagnosis and treatment of multisystemic inflammatory syndrome in children with COVID-19. Methodology. A systematic review of publications indexed in the following browsers was performed: PubMed, Scopus, Web of Science, since 2017, those that had some relation with the subject to be treated were chosen, in a complementary way this search was performed using the keywords. Results. A total of 26 articles related to the topic were found, reflecting that multisystemic inflammatory syndrome is present in a large percentage of children who suffered COVID-19, MIS is characterized by fever, gastrointestinal manifestations, changes in the oral mucosa and skin rash. Laboratory and imaging tests are used to diagnose this pathology. Treatment consists of applying IV immunoglobulin. Conclusion. Being a pathology of recent appearance in children it is important to study it and define the different components for an adequate diagnosis and treatment.
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Bautista Vanegas, S. E., & Mesa Cano, I. C. (2023). Symptomatology, diagnosis, and treatment of multisystemic inflammatory syndrome in post covid-19 infants: literature review. Ciencia Digital, 7(1), 157-189. https://doi.org/10.33262/cienciadigital.v7i1.2483
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References
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Álvarez, P., Urdiales, A., Vélez, I., Melan, B., Carreño, M., & Fajardo, I. (2021). Covid-19 and multisystem inflammatory syndrome in children. Revista Latinoamericana de Hipertension, 15(3), 160–170. https://doi.org/10.5281/ZENODO.5514078
Antúnez, O., Escamilla, M., Figueroa, A., Arteaga, E., Lavariega, M., Salcedo, P., Melchior, P., De Oliveira, R., Tirado, J., Redondo, H., Montes, L., Hernandez, R., Chavez, C., Campos, F., Uribe, F., Del Aguila, O., Rios, J., Buitrago, A., Betancur, L., … Buonsenso, D. (2020). COVID-19 and Multisystem Inflammatory Syndrome in Latin American Children: A Multinational Study. Pediatric Infectious Disease Journal, 2(3), 170–188. https://doi.org/10.1097/INF.0000000000002949
Cobos, A., & Augustovski, F. (2011). Declaración CONSORT 2010: actualización de la lista de comprobación para informar ensayos clínicos aleatorizados de grupos paralelos. Medicina Clínica, 137(5), 213–215. https://doi.org/10.1016/J.MEDCLI.2010.09.034
De Coll, L., Zamudio, M., Nuñez Hector, Bernal, R., Schult, S., Corahua, M., Huby, C., Castillo, C., Candela, J., Aranda, F., & Rojas, R. (2020). COVID-19-associated multisystem inflammatory syndrome in children: case series at a pediatric hospital in Peru. Revista Peruana de Medicina Experimental y Salud Publica, 37(3), 559–565. https://doi.org/10.17843/RPMESP.2020.373.6126
Ensinck, G., Gregorio, G., Flores, R. M., Crowe, C. I., Clerico Mosina, P., Curi, C., Jorro Barón, F., Kohn Loncarica, G., Grinenco, S., Ríos, C., González, C., Zaslavsky, V., de Lillo, L., Vainstein, E., & Urrutia, L. (2021). Consensus on treatment of multisystemic inflammatory syndrome associated with COVID-19. Archivos Argentinos de Pediatria, 119(4), S198–S211. https://doi.org/10.5546/AAP.2021.S198
Fallas, M., Fung, P., Guzmán, A., Vargas, S., & Quirós, P. (2021). Síndrome inflamatorio multisistémico pediátrico. Revista Medica Sinergia, 6(5), e664–e664. https://doi.org/10.31434/RMS.V6I5.664
Feldstein, L., Tenforde, M., Friedman, K., Newhams, M., Rose, E. B., Dapul, H., Soma, V., Maddux, A., Mourani, P., Bowens, C., Maamari, M., Hall, M., Riggs, B., Giuliano, J., Singh, A., Li, S., Kong, M., Schuster, J., McLaughlin, G., … Randolph, A. (2021). Characteristics and Outcomes of US Children and Adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C) Compared with Severe Acute COVID-19. JAMA - Journal of the American Medical Association, 325(11), 1074–1087. https://doi.org/10.1001/JAMA.2021.2091
García, A., Antón, J., Martínez, J., Garcia, G., Cortés, B., & Tagarro, A. (2021). Spanish consensus document on diagnosis, stabilisation and treatment of pediatric multisystem inflammatory syndrome related to SARS-CoV-2 (SIM-PedS). Anales de Pediatría (English Edition), 94(2), 116.e1-116.e11. https://doi.org/10.1016/j.anpede.2020.09.005
Götzinger, F., Santiago, B., Noguera, A., Lanaspa, M., Lancella, L., Calò, F., Gabrovska, N., Velizarova, S., Prunk, P., Osterman, V., Krivec, U., Lo Vecchio, A., Shingadia, D., Soriano, A., Melendo, S., Lanari, M., Pierantoni, L., Wagner, N., L’Huillier, A. G., … Riordan, A. (2020). COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. The Lancet. Child & Adolescent Health, 4(9), 653–661. https://doi.org/10.1016/S2352-4642(20)30177-2
Hernandez, J., Herrera, R., Lequerica, P., Hernandez, J., Herrera, R., & Lequerica, P. (2021). ¿Qué sabemos de la enfermedad de Kawasaki y COVID 19? Andes Pediatrica, 92(2), 281–287. https://doi.org/10.32641/ANDESPEDIATR.V92I2.2786
Izquierdo, G., Cofré, F., Poli, C., Delpiano, L., Conca, N., Verdugo, P., Alvarez, P., Acevedo, V., & Tapia, L. (2021). Recommendations for the suspected diagnosis and management of Multisystemic Inflammatory Syndrome (MIS-C) in the context of a SARS-CoV-2 pandemic. Revista Chilena de Infectologia : Organo Oficial de La Sociedad Chilena de Infectologia, 38(3), 370–380. https://doi.org/10.4067/S0716-10182021000300370
Morilla, L., Morel, Z., & Pavlicich, V. (2020). Clinical characteristics of pediatric patients with COVID-19 in an emergency department. Pediatría (Asunción). https://doi.org/10.31698/ped.47032020002
Nijman, R. G., De Guchtenaere, A., Koletzko, B., Ross Russell, R., Copley, S., Titomanlio, L., del Torso, S., & Hadjipanayis, A. (2020). Pediatric Inflammatory Multisystem Syndrome: Statement by the Pediatric Section of the European Society for Emergency Medicine and European Academy of Pediatrics. Frontiers in Pediatrics, 8(2), 490. https://doi.org/10.3389/FPED.2020.00490/BIBTEX
Noval Rivas, M., Porritt, R. A., Cheng, M. H., Bahar, I., & Arditi, M. (2021). COVID-19–associated multisystem inflammatory syndrome in children (MIS-C): A novel disease that mimics toxic shock syndrome—the superantigen hypothesis. Journal of Allergy and Clinical Immunology, 147(1), 57–59. https://doi.org/10.1016/j.jaci.2020.10.008
Organizacion Mundial de Salud, O. (2019). Coronavirus. Health Topics. https://www.who.int/es/health-topics/coronavirus#tab=tab_1
Pérez, E., & Percy, E. (2021). Síndrome inflamatorio multisistémico en niños asociado a COVID-19. Revista Cubana de Pediatría, 93(4). http://www.revpediatria.sld.cu/index.php/ped/article/view/1339
Raab, C. (2019). Enfermedad de Kawasaki - Pediatría. Manual MSD Versión Para Profesionales. https://www.msdmanuals.com/es-ec/professional/pediatría/trastornos-diversos-en-lactantes-y-niños/enfermedad-de-kawasaki-ek
Rodríguez, R., & Rivera, M. (2020). Multisystemic inflammatory syndrome associated with COVID-19 in children and adolescents. Revista Latinoamericana de Infectología Pediátrica, 33(3), 115–118. https://doi.org/10.35366/95645
Sánchez, R., Fatahi, M., García, E., Edo, M., & Alonso, E. (2021). Clinical and radiological findings for the new multisystem inflammatory syndrome in children associated with COVID-19. Radiologia, 63(4), 334–344. https://doi.org/10.1016/J.RXENG.2021.03.005
Shioji, N., Aoyama, K., Englesakis, M., Annich, G., & Maynes, J. (2021). Multisystem inflammatory syndrome in children during the coronavirus disease pandemic of 2019: a review of clinical features and acute phase management. Journal of Anesthesia, 35(4), 563–570. https://doi.org/10.1007/S00540-021-02952-6
Taffarel, P., Jorro, F., Rodríguez, A., Widmer, J., & Meregallia, C. (2021). Multisystem inflammatory syndrome in children related to COVID-19: An update regarding the presentation of two critically ill patients. Archivos Argentinos de Pediatria, 119(1). https://doi.org/10.5546/AAP.2021.ENG.E26
Tolunay, O., Çelik, Ü., Arslan, C., Orgun, A., Demir, H., Demir, O., & Daǧdelen, E. (2021). Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Case Series Experience in a Tertiary Care Hospital of Southern Turkey. Journal of Tropical Pediatrics, 67(2). https://doi.org/10.1093/TROPEJ/FMAB050
Ulloa, R., Ivankovich, G., & Yamazaki, M. (2020). Multisystem inflammatory syndrome associated with COVID19 in children and adolescents: calling for diagnosis. Revista Chilena de Infectologia : Organo Oficial de La Sociedad Chilena de Infectologia, 37(3), 199–201. https://doi.org/10.4067/S0716-10182020000300199
Urrútia, G., & Bonfill, X. (2010). PRISMA declaration: A proposal to improve the publication of systematic reviews and meta-analyses. Medicina Clinica, 135(11), 507–511. https://doi.org/10.1016/J.MEDCLI.2010.01.015
Van Doremalen, N., Bushmaker, T., Morris, D. H., Holbrook, M., Gamble, A., Williamson, B., Tamin, A., Harcourt, J., Thornburg, N., Gerber, S., Lloyd-Smith, J., de Wit, E., & Munster, V. (2020). Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. The New England Journal of Medicine, 382(16), 1564–1567. https://doi.org/10.1056/NEJMC2004973
Verdoni, L., Mazza, A., Gervasoni, A., Martelli, L., Ruggeri, M., Ciuffreda, M., Bonanomi, E., & D’Antiga, L. (2020). An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. The Lancet, 395(10239), 1771–1778. https://doi.org/10.1016/S0140-6736(20)31103-X/ATTACHMENT/4C10C1C5-DB25-479F-A798-3542D79B625E/MMC1.PDF
Verdugo, P., Álvarez, P., Aroca, P., Montes, V., Poli, C., Tapia, L., Cofré, F., Soto, V., Mackenney, J., Carvajal, C., & Acevedo, V. (2021). Hematologic parameters and biomarkers predictors of severity in Multisystem Inflammatory Syndrome in children associated with SARS-CoV-2. Andes Pediatrica : Revista Chilena de Pediatria, 92(3), 382–388. https://doi.org/10.32641/ANDESPEDIATR.V92I3.3316
Whittaker, E., Bamford, A., Kenny, J., Kaforou, M., Jones, C. E., Shah, P., Ramnarayan, P., Fraisse, A., Miller, O., Davies, P., Kucera, F., Brierley, J., McDougall, M., Carter, M., Tremoulet, A., Shimizu, C., Herberg, J., Burns, J. C., Lyall, H., & Levin, M. (2020). Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA, 324(3), 259–269. https://doi.org/10.1001/JAMA.2020.10369
Yagnam, F., Izquierdo, G., Villena, R., González, C., & Drago, M. (2021). Pediatric Multisystemic Inflammatory Syndrome Temporarily associated with COVID-19: Clinical characteristics and management in a Pediatric Critical Care Unit. Andes Pediatrica : Revista Chilena de Pediatria, 92(3), 395–405. https://doi.org/10.32641/ANDESPEDIATR.V92I3.3333
Álvarez, P., Urdiales, A., Vélez, I., Melan, B., Carreño, M., & Fajardo, I. (2021). Covid-19 and multisystem inflammatory syndrome in children. Revista Latinoamericana de Hipertension, 15(3), 160–170. https://doi.org/10.5281/ZENODO.5514078
Antúnez, O., Escamilla, M., Figueroa, A., Arteaga, E., Lavariega, M., Salcedo, P., Melchior, P., De Oliveira, R., Tirado, J., Redondo, H., Montes, L., Hernandez, R., Chavez, C., Campos, F., Uribe, F., Del Aguila, O., Rios, J., Buitrago, A., Betancur, L., … Buonsenso, D. (2020). COVID-19 and Multisystem Inflammatory Syndrome in Latin American Children: A Multinational Study. Pediatric Infectious Disease Journal, 2(3), 170–188. https://doi.org/10.1097/INF.0000000000002949
Cobos, A., & Augustovski, F. (2011). Declaración CONSORT 2010: actualización de la lista de comprobación para informar ensayos clínicos aleatorizados de grupos paralelos. Medicina Clínica, 137(5), 213–215. https://doi.org/10.1016/J.MEDCLI.2010.09.034
De Coll, L., Zamudio, M., Nuñez Hector, Bernal, R., Schult, S., Corahua, M., Huby, C., Castillo, C., Candela, J., Aranda, F., & Rojas, R. (2020). COVID-19-associated multisystem inflammatory syndrome in children: case series at a pediatric hospital in Peru. Revista Peruana de Medicina Experimental y Salud Publica, 37(3), 559–565. https://doi.org/10.17843/RPMESP.2020.373.6126
Ensinck, G., Gregorio, G., Flores, R. M., Crowe, C. I., Clerico Mosina, P., Curi, C., Jorro Barón, F., Kohn Loncarica, G., Grinenco, S., Ríos, C., González, C., Zaslavsky, V., de Lillo, L., Vainstein, E., & Urrutia, L. (2021). Consensus on treatment of multisystemic inflammatory syndrome associated with COVID-19. Archivos Argentinos de Pediatria, 119(4), S198–S211. https://doi.org/10.5546/AAP.2021.S198
Fallas, M., Fung, P., Guzmán, A., Vargas, S., & Quirós, P. (2021). Síndrome inflamatorio multisistémico pediátrico. Revista Medica Sinergia, 6(5), e664–e664. https://doi.org/10.31434/RMS.V6I5.664
Feldstein, L., Tenforde, M., Friedman, K., Newhams, M., Rose, E. B., Dapul, H., Soma, V., Maddux, A., Mourani, P., Bowens, C., Maamari, M., Hall, M., Riggs, B., Giuliano, J., Singh, A., Li, S., Kong, M., Schuster, J., McLaughlin, G., … Randolph, A. (2021). Characteristics and Outcomes of US Children and Adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C) Compared with Severe Acute COVID-19. JAMA - Journal of the American Medical Association, 325(11), 1074–1087. https://doi.org/10.1001/JAMA.2021.2091
García, A., Antón, J., Martínez, J., Garcia, G., Cortés, B., & Tagarro, A. (2021). Spanish consensus document on diagnosis, stabilisation and treatment of pediatric multisystem inflammatory syndrome related to SARS-CoV-2 (SIM-PedS). Anales de Pediatría (English Edition), 94(2), 116.e1-116.e11. https://doi.org/10.1016/j.anpede.2020.09.005
Götzinger, F., Santiago, B., Noguera, A., Lanaspa, M., Lancella, L., Calò, F., Gabrovska, N., Velizarova, S., Prunk, P., Osterman, V., Krivec, U., Lo Vecchio, A., Shingadia, D., Soriano, A., Melendo, S., Lanari, M., Pierantoni, L., Wagner, N., L’Huillier, A. G., … Riordan, A. (2020). COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. The Lancet. Child & Adolescent Health, 4(9), 653–661. https://doi.org/10.1016/S2352-4642(20)30177-2
Hernandez, J., Herrera, R., Lequerica, P., Hernandez, J., Herrera, R., & Lequerica, P. (2021). ¿Qué sabemos de la enfermedad de Kawasaki y COVID 19? Andes Pediatrica, 92(2), 281–287. https://doi.org/10.32641/ANDESPEDIATR.V92I2.2786
Izquierdo, G., Cofré, F., Poli, C., Delpiano, L., Conca, N., Verdugo, P., Alvarez, P., Acevedo, V., & Tapia, L. (2021). Recommendations for the suspected diagnosis and management of Multisystemic Inflammatory Syndrome (MIS-C) in the context of a SARS-CoV-2 pandemic. Revista Chilena de Infectologia : Organo Oficial de La Sociedad Chilena de Infectologia, 38(3), 370–380. https://doi.org/10.4067/S0716-10182021000300370
Morilla, L., Morel, Z., & Pavlicich, V. (2020). Clinical characteristics of pediatric patients with COVID-19 in an emergency department. Pediatría (Asunción). https://doi.org/10.31698/ped.47032020002
Nijman, R. G., De Guchtenaere, A., Koletzko, B., Ross Russell, R., Copley, S., Titomanlio, L., del Torso, S., & Hadjipanayis, A. (2020). Pediatric Inflammatory Multisystem Syndrome: Statement by the Pediatric Section of the European Society for Emergency Medicine and European Academy of Pediatrics. Frontiers in Pediatrics, 8(2), 490. https://doi.org/10.3389/FPED.2020.00490/BIBTEX
Noval Rivas, M., Porritt, R. A., Cheng, M. H., Bahar, I., & Arditi, M. (2021). COVID-19–associated multisystem inflammatory syndrome in children (MIS-C): A novel disease that mimics toxic shock syndrome—the superantigen hypothesis. Journal of Allergy and Clinical Immunology, 147(1), 57–59. https://doi.org/10.1016/j.jaci.2020.10.008
Organizacion Mundial de Salud, O. (2019). Coronavirus. Health Topics. https://www.who.int/es/health-topics/coronavirus#tab=tab_1
Pérez, E., & Percy, E. (2021). Síndrome inflamatorio multisistémico en niños asociado a COVID-19. Revista Cubana de Pediatría, 93(4). http://www.revpediatria.sld.cu/index.php/ped/article/view/1339
Raab, C. (2019). Enfermedad de Kawasaki - Pediatría. Manual MSD Versión Para Profesionales. https://www.msdmanuals.com/es-ec/professional/pediatría/trastornos-diversos-en-lactantes-y-niños/enfermedad-de-kawasaki-ek
Rodríguez, R., & Rivera, M. (2020). Multisystemic inflammatory syndrome associated with COVID-19 in children and adolescents. Revista Latinoamericana de Infectología Pediátrica, 33(3), 115–118. https://doi.org/10.35366/95645
Sánchez, R., Fatahi, M., García, E., Edo, M., & Alonso, E. (2021). Clinical and radiological findings for the new multisystem inflammatory syndrome in children associated with COVID-19. Radiologia, 63(4), 334–344. https://doi.org/10.1016/J.RXENG.2021.03.005
Shioji, N., Aoyama, K., Englesakis, M., Annich, G., & Maynes, J. (2021). Multisystem inflammatory syndrome in children during the coronavirus disease pandemic of 2019: a review of clinical features and acute phase management. Journal of Anesthesia, 35(4), 563–570. https://doi.org/10.1007/S00540-021-02952-6
Taffarel, P., Jorro, F., Rodríguez, A., Widmer, J., & Meregallia, C. (2021). Multisystem inflammatory syndrome in children related to COVID-19: An update regarding the presentation of two critically ill patients. Archivos Argentinos de Pediatria, 119(1). https://doi.org/10.5546/AAP.2021.ENG.E26
Tolunay, O., Çelik, Ü., Arslan, C., Orgun, A., Demir, H., Demir, O., & Daǧdelen, E. (2021). Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Case Series Experience in a Tertiary Care Hospital of Southern Turkey. Journal of Tropical Pediatrics, 67(2). https://doi.org/10.1093/TROPEJ/FMAB050
Ulloa, R., Ivankovich, G., & Yamazaki, M. (2020). Multisystem inflammatory syndrome associated with COVID19 in children and adolescents: calling for diagnosis. Revista Chilena de Infectologia : Organo Oficial de La Sociedad Chilena de Infectologia, 37(3), 199–201. https://doi.org/10.4067/S0716-10182020000300199
Urrútia, G., & Bonfill, X. (2010). PRISMA declaration: A proposal to improve the publication of systematic reviews and meta-analyses. Medicina Clinica, 135(11), 507–511. https://doi.org/10.1016/J.MEDCLI.2010.01.015
Van Doremalen, N., Bushmaker, T., Morris, D. H., Holbrook, M., Gamble, A., Williamson, B., Tamin, A., Harcourt, J., Thornburg, N., Gerber, S., Lloyd-Smith, J., de Wit, E., & Munster, V. (2020). Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. The New England Journal of Medicine, 382(16), 1564–1567. https://doi.org/10.1056/NEJMC2004973
Verdoni, L., Mazza, A., Gervasoni, A., Martelli, L., Ruggeri, M., Ciuffreda, M., Bonanomi, E., & D’Antiga, L. (2020). An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. The Lancet, 395(10239), 1771–1778. https://doi.org/10.1016/S0140-6736(20)31103-X/ATTACHMENT/4C10C1C5-DB25-479F-A798-3542D79B625E/MMC1.PDF
Verdugo, P., Álvarez, P., Aroca, P., Montes, V., Poli, C., Tapia, L., Cofré, F., Soto, V., Mackenney, J., Carvajal, C., & Acevedo, V. (2021). Hematologic parameters and biomarkers predictors of severity in Multisystem Inflammatory Syndrome in children associated with SARS-CoV-2. Andes Pediatrica : Revista Chilena de Pediatria, 92(3), 382–388. https://doi.org/10.32641/ANDESPEDIATR.V92I3.3316
Whittaker, E., Bamford, A., Kenny, J., Kaforou, M., Jones, C. E., Shah, P., Ramnarayan, P., Fraisse, A., Miller, O., Davies, P., Kucera, F., Brierley, J., McDougall, M., Carter, M., Tremoulet, A., Shimizu, C., Herberg, J., Burns, J. C., Lyall, H., & Levin, M. (2020). Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA, 324(3), 259–269. https://doi.org/10.1001/JAMA.2020.10369
Yagnam, F., Izquierdo, G., Villena, R., González, C., & Drago, M. (2021). Pediatric Multisystemic Inflammatory Syndrome Temporarily associated with COVID-19: Clinical characteristics and management in a Pediatric Critical Care Unit. Andes Pediatrica : Revista Chilena de Pediatria, 92(3), 395–405. https://doi.org/10.32641/ANDESPEDIATR.V92I3.3333