Clinical features, diagnosis, complications, and treatment of multisystem inflammatory syndrome in children MIS-C during the COVID-19 pandemic: a systematic review
Clinical features, diagnosis, complications, and treatment of multisystem inflammatory syndrome in children MIS-C during the COVID-19 pandemic: a systematic review

Summary/Abstract: Introduction Since December 2019, severe acute respiratory syndrome coronavirus-2 SARS-CoV-2, the etiologic agent of COVID-19, has been widely spreading through the world and has become a global pandemic, according to the World Health Organization. Most pediatric patients with COVID-19 are asymptomatic or show only mild symptoms, However, an increase in the number of the children with SARSCoV-2 presented with a significant systemic inflammatory response similar to Kawasaki syndrome, known as multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS), supporting the idea that COVID-19 is a triggering factor. Methods A comprehensive search strategy was designed to retrieve all articles published from October 2019 to 30 June 2020, by using the terms COVID-19, SARS-CoV-2, Coronavirus, Kawasaki, multisystem inflammatory syndrome, Kawasaki syndrome, cytokine storm and myocarditis in several electronic databases and Government Agencies Websites (PubMed, Google Scholar, Centers for Disease Control and Prevention, WHO and UK Royal College of Pediatrics and Child Health). Retrospective observational studies, case series, and case report studies about the main clinical characteristics, laboratory results, treatment, and patients' responses were included. Conclusions MIS-C leads to serious life-threatening conditions in children and adolescence, including toxic shock syndrome (TSS) and cardiac involvement. This paper aimed to bring this subset of children to the attention of clinicians to optimize early recognition and management of this syndrome during the pandemic. We summarized the main clinical pictures, defined laboratory findings, and illustrated the optimal treatment of children with MIS-C related to SARS-CoV-2 to help clinicians to reduce mortality and morbidity of the disease.

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