According to the World Health Organisation, as of October 2022, there have been 55,560,329 reported cases of SARS‐COV‐2 in patients under 19 years old. It is estimated that about 0.06% of these patients may develop MIS‐C, representing more than 2 million children worldwide. This systematic review and meta‐analysis examined the pooled prevalence of cardiovascular manifestation and cardiac complications in children hospitalised with MIS‐C. The PROSPERO register number is CRD42022327212. We included case‐report studies, case‐control studies, cohort studies, and cross‐sectional studies, as well as clinical trials or studies describing cardiac manifestations of MIS‐C and its sequelae in a paediatric population. Initially, 285 studies were selected, but there were 154 duplicates, and 81 were excluded because they did not fit the eligibility criteria. Thus, 50 studies were selected for review, and 30 were included in the meta‐analysis. A total sample size of 1445 children was included. The combined prevalence of myocarditis or pericarditis was 34.3% (95% CI: 25.0%–44.2%). The combined prevalence for echocardiogram anomalies was 40.8% (95% CI: 30.5%–51.5%), that of Kawasaki disease presentation was 14.8% (95% CI: 7.5%–23.7%), and that of coronary dilation was 15.2% (95% CI: 11.0%–19.8%). The rate of electrocardiogram anomalies was 5.3% (95% CI: 0.8%–12.3%), and the mortality rate was 0.5% (CI 95%: 0%–1.2%). Furthermore, 186 children still had complications at discharge, with a combined prevalence of such long‐lasting manifestations of 9.3% (95% CI: 5.6%–13.7%). Studies that assess whether these children will have an increased cardiovascular risk with a greater chance of acute myocardial infarction, arrhythmias, or thrombosis will be essential for healthcare planning.

Background Brazil is a middle‐income country that aims to provide universal health coverage, but its surgical system's efficiency has rarely been analyzed. In an effort to strengthen surgical national systems, the Lancet Commission on Global Surgery proposed bellwether procedures as quality indicators of surgical workforces. This study aims to evaluate regional inequalities in access to bellwether procedures and their associated mortality across the five Brazilian geographical regions. Methods Using DATASUS, Brazil's national healthcare database, data were collected on the total amount of performed bellwether procedures—cesarean section, laparotomy, and open fracture management—and their associated mortality, by geographical region. We evaluated the years 2018–2020, both in emergent and elective conditions. Statistical analysis was performed by one‐way ANOVA test and Tukey's multiple comparisons test. Results During this period, DATASUS registered 2,687,179 cesarean sections, 1,036,841 laparotomies, and 648,961 open fracture treatments. The access and associated mortality related to these procedures were homogeneous between the regions in elective care. There were significant geographical inequalities in access and associated mortality in emergency care (p < 0.05, 95% CI) for all bellwether procedures. The Southeast, the most economically developed region of the country, was the region with the lowest amount of bellwether procedures per 100,000 inhabitants. Conclusion Brazil's public surgical system is competent at promoting elective surgical care, but more effort is needed to fortify emergency care services. Public policies should encourage equity in the geographic allocation of the surgical workforce.

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