COVID-19–Associated Pediatric Multisystem Inflammatory Syndrome

León, María Paz; Redzepi, Ajla; McGrath, Eric; Abdel‐Haq, Nahed; Shawaqfeh, Ahmed; Sethuraman, Usha; Tilford, Bradley; Chopra, Teena; Arora, Harbir; Ang, Jocelyn Y.; Asmar, Basim I.

doi:10.1093/jpids/piaa061

Cited by 106 publications

(95 citation statements)

References 3 publications

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“…We identified a total of 34 case series 3 , 6 , 7 , 8 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 and case reports 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 published between May and July 2020 that mention dermatologic findings in 736 unique children with MIS-C. Cutaneous manifestations were present in 417 of 736 patients (57%). Fifteen (44%) of these articles state “rash” as the sole descriptor of skin findings.…”

Section: Dermatologic Presentationmentioning

confidence: 99%

“…Some smaller case series and case reports provide more detailed characterizations: polymorphic, maculopapular, morbilliform, and diffuse erythroderma were the most common morphologies noted. 3 , 25 , 34 , 38 , 39 , 40 , 45 , 46 , 48 , 51 Skin lesions in single case reports were described as urticarial 34 , reticular 47 , petechial 32 , and purpuric. 46 …”

Section: Dermatologic Presentationmentioning

confidence: 99%

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Dermatologic manifestations of COVID-19-associated multisystem inflammatory syndrome in children

Brumfiel

DiLorenzo

Petronic‐Rosic

2021

Clinics in Dermatology

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Multisystem inflammatory syndrome in children (MIS-C) affects a small percentage of pediatric patients infected with COVID-19 and is characterized by fever, laboratory evidence of inflammation, multisystem involvement, and severe illness necessitating hospitalization. Skin findings are often present in these patients and while initially compared to Kawasaki disease, likely represent distinct phenomena and overall remain poorly characterized. In this retrospective review of 34 case reports and series, we identified cutaneous manifestations documented in 417 of 736 patients (57%) with MIS-C associated with COVID-19. “Rash” was the sole descriptor of skin findings in nearly half of patients. Case reports and smaller case series provided more detail, outlining a broad range of lesion morphologies (polymorphic, maculopapular, morbilliform, erythrodermic, urticarial, reticular, petechial, purpuric) in variable anatomic distribution. More thorough descriptions of dermatologic manifestations in patients with MIS-C are warranted to better characterize this syndrome, as they may lend important insight into pathogenic mechanisms of disease.

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Section: Dermatologic Presentationmentioning

confidence: 99%

Section: Dermatologic Presentationmentioning

confidence: 99%

Dermatologic manifestations of COVID-19-associated multisystem inflammatory syndrome in children

Brumfiel

DiLorenzo

Petronic‐Rosic

2021

Clinics in Dermatology

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“…Riphagen et al [7] Reino Unido Serie de casos Rivera et al [20] Reino Unido Toubiana et al [3] Francia Serie de casos Toubiana et al [16] Francia Serie de casos Verdoni et al [17] Italia Serie de casos Whittaker et al [18] Reino Unido Serie de casos 58 9 (5,(7)(8)(9)(10)(11)(12)(13)(14) 33 (57,0) Fiebre, rash, conjuntivitis, cambios en las cavidad oral y labios, linfadenopatía.…”

Section: Inmunoglobulina (50) 14unclassified

“…Hubo un total de 364 casos reportados, las edades de los pacientes se encontraban entre los 6 meses y los 16,6 años. Entre las características clínicas halladas se destacaron fiebre [6][7][8][9][10][11][12][13][14][15][16][17][18] , eritema no pruriginoso [14] , sarpullido con manchas [9,[10][11][12][13]15,16,18,19] , labios secos y agrietados [3,[7][8][9][10][11]15,[17][18][19][20] y linfadenopatía cervical [3,11,12,[15][16][17][18][19][20] . El tratamiento común fue la inmunoglobulina y el ácido acetilsalicílico.…”

Section: Inmunoglobulina (50) 14unclassified

“…Posteriormente se escogió por texto completo (excluyéndose editoriales, revisiones sistemáticas y cartas al editor no relacionadas) y finalmente se realizó un cuadro con los 16 estudios resultantes (Tabla 1). Días de hospitalización (DS o rango) Cheung et al [8] Estados Chiotos et al [9] Estados Unidos Serie de casos Deza et al [10] Estados Unidos Reporte de caso 1 6 1 (100) Fiebre, rash, conjuntivitis, cambios en los labios, edema de pies y manos, hipotensión, miocarditis.…”

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Fin del confinamiento y enfermedad similar a Kawasaki en niños: a propósito de COVID-19

2020

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American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS–CoV‐2 and Hyperinflammation in Pediatric COVID‐19: Version 1

Henderson

Canna

Friedman

et al. 2020

Arthritis & Rheumatology

426

613

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Objective To provide guidance on the management of multisystem inflammatory syndrome in children (MIS‐C), a condition characterized by fever, inflammation, and multiorgan dysfunction that manifests late in the course of severe acute respiratory syndrome coronavirus 2 (SARS–CoV‐2) infection, and to provide recommendations for children with hyperinflammation during coronavirus disease 2019 (COVID‐19), the acute, infectious phase of SARS–CoV‐2 infection. Methods A multidisciplinary task force was convened by the American College of Rheumatology (ACR) to provide guidance on the management of MIS‐C associated with SARS–CoV‐2 and hyperinflammation in COVID‐19. The task force was composed of 9 pediatric rheumatologists, 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS‐C and hyperinflammation in COVID‐19 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved 2 rounds of anonymous voting and 2 webinars. A 9‐point scale was used to determine the appropriateness of each statement (median scores of 1–3 for inappropriate, 4–6 for uncertain, and 7–9 for appropriate), and consensus was rated as low, moderate, or high based on dispersion of the votes along the numeric scale. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, as prespecified prior to voting. Results The ACR task force approved a total of 128 guidance statements addressing the management of MIS‐C and hyperinflammation in pediatric COVID‐19. These statements were refined into 40 final clinical guidance statements, accompanied by a flow diagram depicting the diagnostic pathway for MIS‐C. Conclusion Our understanding of SARS–CoV‐2–related syndromes in the pediatric population continues to evolve. The guidance provided in this “living document” reflects currently available evidence, coupled with expert opinion, and will be revised as further evidence becomes available.

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COVID-19–Associated Pediatric Multisystem Inflammatory Syndrome

Cited by 106 publications

References 3 publications

Dermatologic manifestations of COVID-19-associated multisystem inflammatory syndrome in children

Dermatologic manifestations of COVID-19-associated multisystem inflammatory syndrome in children

Fin del confinamiento y enfermedad similar a Kawasaki en niños: a propósito de COVID-19

American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS–CoV‐2 and Hyperinflammation in Pediatric COVID‐19: Version 1

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