Initially, SARS-CoV-2 infection had been reported as a relatively mild case in children than in adults. Nevertheless, recent evidence found that a subset of children then developed a significant systemic inflammatory response that resembles atypical/typical Kawasaki’s disease (KD) and toxic shock syndrome. This novel clinical syndrome later identified as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). In contrast with KD, PIMS-TS appears to occur in children at an older age with a predominance of gastrointestinal symptoms, hemodynamic instability, and myocardial dysfunction. However, the exact pathomechanism remains to be understood. Nevertheless, the post-viral immunological reaction is postulated to be the underlying mechanistic underpinnings. The multifaceted nature of the PIMS-TS’ course underlines the need for early recognition and multispecialty care and management.

Objective To investigate cardiac manifestations, treatment characteristics, and outcomes of paediatric inflammatory multisystem syndrome (PIMS) temporally associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (PIMS-TS) Method We performed a comprehensive literature search of several databases and qualitatively synthesized findings from studies. Results Twenty-six studies were included with 1228 pooled subjects, with a mean age of 8.6 years, which were dominated by male gender (53%), and African ethnicity (31%). 732 (38%) patients were reactive on a serological test, and 457 patients (45%) were positive on SARS-CoV-2 RT-PCR. ST-segment abnormalities were the most common ECG findings (16%, n/N: 34/212). Various markers of troponin and the pooled mean of BNP and NT-pro-BNP levels were elevated. Cardiomegaly and pericardial effusion (21.8%, n/N: 164/751) was the most common chest X-ray findings. In echocardiography, the majority of patients’ left ventricular ejection fraction was reduced (59.0%, n/N: 180/305), with pericardial effusion/ pericarditis seen the most (17.44%, n/N: 221/1267), and Z score ≥ 2 in 28% (n/N: 42/139). Cardiac MRI findings were consistent with acute myocarditis. Intravenous immunoglobulin, corticosteroids, and vasoactive drugs were frequently utilized. The mean length of stay was 6 days, with most patients (71%, n/N: 834/1163) were admitted to the ICU. However, the overall prognosis was favourable, with 98% alive (n/N: 1235/1260), and more than 50% of patients experienced recovery of left ventricular systolic functions at discharge (116 out of 206 patients). Conclusion PIMS-TS is a rare clinical syndrome associated with a multiorgan system dysfunction, especially acute cardiac injury, and mandates a higher level of care. Nevertheless, when appropriate treatments are available, the cardiac function rapidly reverted to normal in most cases, and it was associated with a favourable outcome in general. Of concern, medium and long-term prognosis remains to be elucidated.

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Pendahuluan: Pendidikan merupakan bagian dari proses belajar seorang anak untuk membentuk kemampuan kognitif dan kepribadian yang baik. Anak yang tidak mampu melakukan koordinasi kemampuan berpikir, sistem integrasi sensorik dan motorik, atau fungsi verbal dan non-verbal dapat mengalami gangguan belajar. Ketidakmampuan membaca (disleksia), menulis (disgrafia), maupun berhitung (diskalkulia) merupakan domain dari gangguan belajar spesifik pada anak. Identifikasi dan intervensi pada anak dengan gangguan belajar memerlukan kerja sama tenaga medis, guru dan orangtua. Kasus: Anak laki-laki, usia tujuh tahun memiliki hambatan dalam membaca berdasarkan pengamatan selama enam bulan oleh guru sekolah sejak anak belajar di kelas satu sekolah dasar. Anak sehat secara fisik, tumbuh kembang sesuai usia dan mampu berinteraksi baik dengan teman sekolah maupun lingkungan rumah. Pasien memenuhi kriteria gangguan belajar spesifik domain membaca sesuai dengan Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Pasien sudah menjalani intervensi yang adekuat untuk mengatasi gangguan belajar spesifik dan berhasil naik kelas dua sekolah dasar dengan kemajuan kemampuan membaca. Simpulan: Pentingnya identifikasi dan intervensi dini serta permantauan berkelanjutan pada anak dengan gangguan belajar spesifik untuk mencapai kualitas hidup yang optimal.