Children’s Multisystem Inflammatory Syndrome, Associated With a New Coronavirus Infection (COVID-19): Relevant Information and Clinical Observation

Abstract

Background. New coronaviral infection (COVID-19) in most cases has less severe course in children than in adults. However, there were reports from the number of European countries and from United States (from March 2020) about children with new disease with signs of Kawasaki disease (KD) and toxic shock syndrome (TSS). So it has received one of the names children’s multisystem inflammatory syndrome (CMIS) associated with COVID-19. The aim of the study is to summarize up-to-date information about this disease.Methods. Information search in PubMed database, CDC (USA) and WHO websites, Search for information in PubMed database, on CDC (USA) and WHO websites, analysis of the medical records of observed patient with CMIS.Results. Clinical and laboratoryinstrumental manifestation and outcomes of CMIS in 120 children from Italy, France, Switzerland, England, USA with similar signs were analyzed. Proposed international diagnostic criteria of the disease in comparison with other phenotypically similar diseases (KD, shock syndrome at KD, TSS of Staphylococcal and Streptococcal etiology, macrophage activation syndrome), clinical observation of patient, algorithm of evaluation and management of patients with CMIS are presented.

Complications from the cardiovascular system in children who have had COVID-19

“…2 children with a severe course of the disease developed PMIS, which required transfer to the ICU. Our data are consistent with the literature, which shows that the moderate course of pneumonia without respiratory failure is approximately 40%, the frequency of severe course is 2.5-7.6%, and extremely severe is less than 1% [7]. According to the results of a systematic review including 1065 patients under the age of 19 years, this infection occurs in children mainly with mild respiratory and general symptoms or asymptomatic [7,10].…”

“…They had signs of toxic shock syndrome, myocarditis with cardiogenic shock, called "pediatric multisystem inflammatory syndrome (PMIS)" [6]. Children developed fever (>38.5°C), cardiogenic shock or acute left ventricular (LV) dysfunction, LV ejection fraction <50%), C-reactive protein (CRP) content >100 mg/ml [7]. As given in the article, 17% of children had overweight and 9% had bronchial asthma among concomitant diseases.…”

“…The pathogenesis and pathoanatomical picture of COVID-19 is characterized by the development of generalized microangiopathy, manifested by the development of destructive-productive viral vasculitis and hypercoagulable syndrome. In the future, secondary lesions of the skin, internal organs, central nervous system and hemophagocytosis develop [7,10,11]. In this regard, in May 2020, recommendations were developed for the diagnosis and management of patients with PMIS [6,7].…”

“…In the future, secondary lesions of the skin, internal organs, central nervous system and hemophagocytosis develop [7,10,11]. In this regard, in May 2020, recommendations were developed for the diagnosis and management of patients with PMIS [6,7]. According to the authors, therapy depends on the clinical manifestations and severity of the disease.…”

Coronavirus disease in children in the Omsk region

“…Некоторое различие клинической картины новой коронавирусной инфекции отмечается и в детском возрасте, которое связано, с одной стороны, с анатомо-физиологическими особенностями у детей, с другой -c отсутствием длительного воздействия вредных факторов (например, никотина) и тяжелых хронических заболеваний. В последнее время дискутируется вопрос о меньшей экспрессии ACE2 рецепторов у детей по сравнению с взрослыми людьми [9]. Таким образом, изучение особенностей коронавирусной инфекции в зависимости от возраста представляет интерес для практического здравоохранения.…”