Childhood multisystem inflammatory syndrome associated with COVID‐19 (MIS‐C): Distinct from Kawasaki disease or part of the same spectrum?

Santaniello, Maria Grazia; Matucci-Cerinic, Caterina; Natoli, Valentina; Trincianti, Chiara; Ridella, Francesca; Ravelli, Angelo

doi:10.1111/pai.13645

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…A delayed multisystem inflammatory syndrome (i.e., MIS-C) may occur in children 2-6 weeks following infection with SARS-CoV-2, in either the presence or absence of symptomatic antecedent viral illness. MIS-C shares many clinical and laboratory features with KD-and sJIA-associated CSS, including fever; pericardial, endocardial, or myocardial inflammation; coronary aneurysm; enteritis; hepatitis; high CRP levels; coagulopathy with elevated d-dimer; and hyperferritinemia (27).…”

Section: Infection-associated Cytokine Storm Syndrome: Triggering Pat...mentioning

confidence: 99%

Cytokine Storm Syndrome

2023

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Cytokine storm syndrome (CSS), which is frequently fatal, has garnered increased attention with the ongoing coronavirus pandemic. A variety of hyperinflammatory conditions associated with multiorgan system failure can be lumped under the CSS umbrella, including familial hemophagocytic lymphohistiocytosis (HLH) and secondary HLH associated with infections, hematologic malignancies, and autoimmune and autoinflammatory disorders, in which case CSS is termed macrophage activation syndrome (MAS). Various classification and diagnostic CSS criteria exist and include clinical, laboratory, pathologic, and genetic features. Familial HLH results from cytolytic homozygous genetic defects in the perforin pathway employed by cytotoxic CD8 T lymphocytes and natural killer (NK) cells. Similarly, NK cell dysfunction is often present in secondary HLH and MAS, and heterozygous mutations in familial HLH genes are frequently present. Targeting overly active lymphocytes and macrophages with etoposide and glucocorticoids is the standard for treating HLH; however, more targeted and safer anticytokine (e.g., anti-interleukin-1, -6) approaches are gaining traction as effective alternatives. Expected final online publication date for the Annual Review of Medicine, Volume 74 is January 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Section: Infection-associated Cytokine Storm Syndrome: Triggering Pat...mentioning

confidence: 99%

Cytokine Storm Syndrome

2023

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“…Although infections with SARS-CoV-2 in children and adolescents are usually mild or even asymptomatic, children with pre-existing medical conditions are considered to be at risk for severe illness [ 8 ]. Furthermore, a rare but severe complication named multisystem inflammatory syndrome in children (MIS-C) has been consistently associated with COVID-19 infection [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Safety after BBIBP-CorV (Sinopharm) COVID-19 Vaccine in Adolescents Aged 10–17 Years in Thailand

et al. 2022

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Coronavirus disease 2019 affected child health and impacted learning because of the resulting onsite school closures. This prospective cohort study included children aged 10–17 who received two 4 µg doses of BBIBP-CorV administered intramuscularly 21–28 days apart. To assess vaccine safety, 36,808 participants were then followed with paper- and web-based online questionnaire surveys that captured local and systemic reactogenicities following vaccine administration on days 1, 7, and 30. Among participants, 76% (27,880) reported reactogenicity within the first 24 h and 7 days following the first dose. Half (51.41%) of participants experienced pain at the injection site; the majority of cases were mild in severity. Injection site tenderness (37.93%) was another common local reaction. Fatigue (37.89%), myalgia (33.56%), and headache (26.76%) were the most common systemic reactions. On days 2–7 after the first dose, 25.85% of participants experienced adverse reactions. Following the second dose, reactogenicity was 7.6% and 1.09% within 24 h and between days 2–7. The majority of reactions were of mild to moderate severity. We report that two doses of the BBIBP-CorV caused mild to moderate side effects in adolescents in Thailand. The findings confirm the vaccine’s safety profile in this age group.

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“…Overlapping symptoms of KD and MIS-C are well documented in the literature. [15][16][17][18] Coronary artery abnormalities (CAA) and aneurysms are serious complications of both illnesses. In our study, 16% of patients developed an aneurysm or dilatation, which were typically detected within 1 day of admission.…”

Section: Discussionmentioning

confidence: 99%

Treatments and Severe Outcomes for Patients Diagnosed With MIS-C at Four Children’s Hospitals in the United States, March 16, 2020–March 10, 2021

Shah,

Abrams,

Godfred-Cato

et al. 2023

Pediatric Infectious Disease Journal

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Background: Clinical management of multisystem inflammatory syndrome in children (MIS-C) has varied over time and by medical institution. Methods: Data on patients with MIS-C were collected from 4 children’s hospitals between March 16, 2020 and March 10, 2021. Relationships between MIS-C treatments and patient demographics, clinical characteristics, and outcomes were described. Propensity score matching was utilized to assess the relative risk of outcomes dependent on early treatment with intravenous immunoglobulin (IVIG) or low-dose steroids, controlling for potential confounding variables. Results: Of 233 patients diagnosed with MIS-C, the most commonly administered treatments were steroids (88.4%), aspirin (81.1%), IVIG (77.7%) and anticoagulants (71.2%). Compared with those patients without respiratory features, patients with respiratory features were less likely to receive IVIG and steroids on the same day (combination treatment) (44.1%). Controlling for confounding variables, patients receiving IVIG within 1 day of hospitalization were less likely to have hospital length of stay ≥8 days (RR = 0.53, 95% CI: 0.31–0.88). Patients receiving low-dose steroids within 1 day of hospitalization were less likely to develop ventricular dysfunction (RR = 0.45, 95% CI: 0.26–0.77), have increasingly elevated troponin levels (RR = 0.55, 95% CI: 0.40–0.75) or have hospital length of stay ≥8 days (RR = 0.46, 95% CI: 0.29–0.74). Conclusion: Treatments for MIS-C differed by hospital, patient characteristics and illness severity. When IVIG and low-dose steroids were administered in combination or low-dose steroids were administered alone within 1 day of hospitalization, the risk of subsequent severe outcomes was decreased.

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Childhood multisystem inflammatory syndrome associated with COVID‐19 (MIS‐C): Distinct from Kawasaki disease or part of the same spectrum?

Cited by 5 publications

References 12 publications

Cytokine Storm Syndrome

Cytokine Storm Syndrome

Safety after BBIBP-CorV (Sinopharm) COVID-19 Vaccine in Adolescents Aged 10–17 Years in Thailand

Treatments and Severe Outcomes for Patients Diagnosed With MIS-C at Four Children’s Hospitals in the United States, March 16, 2020–March 10, 2021

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