Clinical, Laboratory-Instrumental Characteristics, Course and Therapy of Pediatric Multisystem Inflammatory Syndrome Associated With Covid-19

COVID-19 infection usually occurs in children in a mild form, but some of them in a delayed period (one or several weeks after acute infection with COVID-19) may develop a severe inflammatory disease with clinical manifestations similar to toxic shock syndrome (Kawasaki disease), classified as multisystem inflammatory syndrome in children (MISC). It is possible that the syndrome has only a temporary connection with the COVID-19 infection. In the future, new associations of such clinical manifestations with other infectious (or non-infectious) diseases may appear. But currently, all children in the described cohorts with MISC have an association with COVID-19 infection. It is believed that the syndrome is initiated by an excessive adaptive immune response with the formation of autoantibodies. Treatment is based on anti-inflammatory, including steroid therapy, the possible use of intravenous immunoglobulin, aspirin, interleukin 1 and 6 receptor antagonists. The article analyzes current views on Kawasaki-multisystem inflammatory syndrome in children in the delayed period of COVID-19 coronavirus infection in the aspects of diagnosis, pathogenesis, clinical manifestations (with a discussion of foreign and Russian studies) and approaches to therapy and possible prevention, including the possibility of using plasmapheresis in complex therapy.

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Kawasaki-multisystem inflammatory syndrome in children in the delayed period of coronavirus infection (covid-19): modern state of the problem and possible new approaches to treatment (plasmapheresis)

Грознова

Warriors

Donich

et al. 2021

Pediatr (SPb)

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Features of laboratory parameters in children with multisystem inflammatory syndrome associated with SARS-CoV-2

Обухова

Ryabichenko

Karpovich

et al. 2022

Sibirskij nauchnyj medicinskij zhurnal

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Multisystem inflammatory syndrome (MIS-C) is a new childhood disease associated with coronavirus SARS-CoV-2 that manifests itself 3–4 weeks after infection. The development of MIS-C is possible, despite the asymptomatic course of coronavirus infection. The pathogenetic features of MIS-C remain unclear. The aim of the study was to investigate the state of peripheral blood parameters in children with multisystem inflammatory syndrome associated with SARS-CoV-2 upon admission to a hospital. Material and methods. We examined 52 children with MIS-C from 1 to 14 years old, hospitalized in Children`s Clinical Hospital No. 3 in Novosibirsk in October–December 2020. Testing for the isolation of SARS-CoV-2 RNA in scrapings from the nasopharynx and oropharynx was carried out using real time PCR (test systems of DNA-Technology, Russia). The presence of specific IgM and IgG antibodies to SARS-CoV-2 in blood serum was determined by ELISA using Vector-Best kits (Russia). Results and discussion. It was noted that SARS-CoV-2 virus RNA was found only in 12.8 % of cases, while specific IgG antibodies in blood serum were detected in 100 % of children. IgM to SARS-CoV-2 antigens were detected in the blood serum only in 53.85 % of children with MIS-C. It has been established that unexpressed leukocytosis was found both in children under the age of 7 and in children of 8–14 years old. However, the leukocytes content in children of the older age group was significantly lower than in children aged 1–7 years. At the same time, in both age groups, some children had extremely low values of the indicator. The causes of severe leukopenia against the background of excessive inflammation remain unclear. Age groups (1–7 and 8–14 years) do not differ statistically significantly in the relative content of lymphocytes and neutrophils. In the study of individual values of the relative content of lymphocytes within the age groups, it was noted that only some children had lymphopenia of varying severity. Conclusions. Against the background of minor leukocytosis in children with MIS-C, upon admission to the hospital, there is a tendency to develop both relative and absolute lymphopenia, regardless of age. The study noted an extremely pronounced variability of individual values of the evaluated peripheral blood parameters, regardless of age, which, with similar clinical symptoms, characterized as MIS-C, requires further study in dynamics, taking into account the initial values of the indicators.There is no pronounced relationship between the leukocytes content and specific IgM antibodies to SARS-CoV-2 antigens in the blood.

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Clinical Characteristics of Rheumatic Diseases and Children Multisystem Inflammatory Syndrome Associated With COVID-19

Saatova

Uzakbaev

Furtikova

et al. 2021

BSP

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With a new coronavirus infection, almost all organism systems are involved in the pathological process, which leads to development during the disease or post-COVID period of both new diseases and complications of existing chronic diseases requiring treatment or rehabilitation. The remaining after the suffered disease symptom complex complaints and clinical manifestations can be disturbed without conducting therapy and rehabilitation over many months. Purpose of the study. Present on their own observations of the laws of the clinical picture and therapies of the treatment of children’s multisystem inflammatory syndrome and systemic diseases of the connective tissue associated with COVID-19. Research results. Presented in Kyrgyzstan series of own clinical observations of 31 patients with children’s multisystem inflammatory syndrome and 23 patients with systemic diseases of the connective tissue associated with COVID-19, and 29 — with exacerbation of the systemic diseases of the connective tissue due to the transferred coronavirus infection, demonstrates the etiological and pathogenic significance SARS COV2 in the emergence of a severe system of inflammatory response. Timely anti-inflammatory treatment of children’s multisystem inflammatory syndrome is crucial and must be adapted for each patient in order to achieve the most favorable effect. Patients of the systemic diseases of the connective tissue account for a risk group with regard to the disease COVID-19 and the unfavorable disease.

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Clinical, Laboratory-Instrumental Characteristics, Course and Therapy of Pediatric Multisystem Inflammatory Syndrome Associated With Covid-19

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Kawasaki-multisystem inflammatory syndrome in children in the delayed period of coronavirus infection (covid-19): modern state of the problem and possible new approaches to treatment (plasmapheresis)

Kawasaki-multisystem inflammatory syndrome in children in the delayed period of coronavirus infection (covid-19): modern state of the problem and possible new approaches to treatment (plasmapheresis)

Features of laboratory parameters in children with multisystem inflammatory syndrome associated with SARS-CoV-2

Clinical Characteristics of Rheumatic Diseases and Children Multisystem Inflammatory Syndrome Associated With COVID-19

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