Update on the treatment of multisystem inflammatory syndrome in children associated with COVID-19

Long, Fangyuan; Zhu, Shiheng; Wang, Zeguang; Zhang, Shungeng; He, Jiajia; Ge, Xinbin; Ning, Jun

doi:10.2217/fvl-2022-0048

Cited by 3 publications

(4 citation statements)

References 68 publications

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“…MIS patients are treated with different treatment regimens, mostly revolving around the use of glucocorticoids, and immunomodulatory medications, including intravenous immune globulin (IVIG), as first-tier therapy. The patients who are refractory to glucocorticoids and IVIG warrants a step-up of immunomodulatory therapy to therapeutic plasmapheresis [ 50 ] and biological agents such as anakinra, tocilizumab, and infliximab [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review

Elsaid,

Nune,

Hesham

et al. 2023

Trop Dis Travel Med Vaccines

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Background Although SARS-CoV-2 vaccines are generally safe, there are growing concerns about their link to a potentially life-threatening multi-system inflammatory syndrome following vaccination (MIS-V). We conducted this systematic review to elucidate the prevalence of MIS, severity, treatment, and outcomes following SARS-CoV-2 vaccination. Methods We searched PubMed, Scopus, ScienceDirect, Google Scholar, Virtual Health Library (VHL), Cochrane Library, and Web of Science databases for articles and case reports about MIS-V. We performed a qualitative analysis of individual cases from the included studies. Results Of the 1366 studies identified by database search, we retrieved twenty-six case reports and two cohort studies. We analyzed the data of 37 individual cases extracted from 27 articles. The average age of the cases included in this review was 18 (1–67) years, with the most being male (M: F 3.1:1). Of the 37 included cases, the cardiovascular system was the most affected system by MIS (36, 97.3%), followed by the gastrointestinal tract (32, 86.5%). Conclusion MIS after SARS-CoV-2 vaccinations can be fatal, but the incidence is low. Prompt recognition of MIS and ruling out the mimickers are critical in the patient’s early recovery.

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Section: Discussionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review

Elsaid,

Nune,

Hesham

et al. 2023

Trop Dis Travel Med Vaccines

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“… 1 Multisystem inflammatory syndrome in children is similar to Kawasaki disease, and patients with MIS‐C have a higher mortality rate than patients with COVID‐19. 2 Likewise, a similar hyperinflammatory multisystem state temporally associated with COVID‐19 has been observed in adults, termed multisystem inflammatory syndrome in adults (MIS‐A). 3 Multisystem inflammatory syndrome in adults also develops approximately 4 weeks after the onset of COVID‐19.…”

Section: Introductionmentioning

confidence: 93%

“…Multisystem inflammatory syndrome in children (MIS‐C) is a rare condition linked to SARS‐CoV‐2, which typically manifests itself 2–5 weeks following infection with SARS‐CoV‐2, and likely occurs as a consequence of a delayed immunologic response to the virus 1 . Multisystem inflammatory syndrome in children is similar to Kawasaki disease, and patients with MIS‐C have a higher mortality rate than patients with COVID‐19 2 . Likewise, a similar hyperinflammatory multisystem state temporally associated with COVID‐19 has been observed in adults, termed multisystem inflammatory syndrome in adults (MIS‐A) 3 .…”

Section: Introductionmentioning

confidence: 99%

Multisystem inflammatory syndrome in adults with COVID‐19 requiring mechanical ventilation: A retrospective cohort study

Kato,

Bunya,

Nakayama

et al. 2023

Acute Medicine & Surgery

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AimMultisystem inflammatory syndrome in adults (MIS‐A) is a hyperinflammatory multisystem condition associated with coronavirus disease (COVID‐19). Critically ill COVID‐19 patients may develop multiorgan damage and elevated inflammatory responses, thus making it difficult to differentiate between progression to organ damage due to COVID‐19 itself or MIS‐A. This study aimed to explore the characteristics and complications of MIS‐A in critical COVID‐19 patients.MethodsThe Japan Extracorporeal Membrane Oxygenation (ECMO) Network and ICU Collaboration Network developed a web‐based database system called the CRoss Intensive Care Unit Searchable Information System (CRISIS) to monitor critical COVID‐19 patients throughout Japan. We retrospectively identified patients with MIS‐A among critical COVID‐19 patients enrolled from March 2020 to December 2021, using CRISIS. Our MIS‐A definition required patients to be at least 18 years of age, have laboratory evidence of inflammation, severe dysfunction of at least two extrapulmonary organ systems, and no plausible alternative diagnoses.ResultsOf the 1052 patients, 26 (2.5%) were diagnosed with MIS‐A. The MIS‐A patients had a higher likelihood of using ECMO (13% vs. 46%, p < 0.001) and lower overall survival (77% vs. 42%, p < 0.001) than non‐MIS‐A patients. More than 80% of the MIS‐A cases occurred 3 weeks after the COVID‐19 onset.ConclusionMultisystem inflammatory syndrome in adults can occur in 2.5% of critically ill COVID‐19 patients, and the mortality rate is high. Multisystem inflammatory syndrome in adults may be considered when there is a re‐elevation of the unexplained inflammatory response and severe dysfunction of at least two extrapulmonary organ systems several weeks after the onset of COVID‐19.

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“…With the emergence of the Delta and Omicron variants in 2021, COVID-19 pediatric cases increased, but not mortality rates [ 16 ]. In rare cases, children who contract SARS-CoV-2 might experience a late manifestation of the disease, multisystem inflammatory syndrome (MIS-C) [ 17 ], which is identified mainly by fever, rash, and gastrointestinal symptoms. MIS-C usually affects children between 8 and 9 years old and can be severe; however, it is a treatable condition, and most children recover fully.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Immune Response against RSV and SARS-CoV-2 Infection in Children

da Silva,

Thomé,

da Souza

2023

Biology

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Viral respiratory tract infections are a significant public health concern, particularly in children. RSV is a prominent cause of lower respiratory tract infections among infants, whereas SARS-CoV-2 has caused a global pandemic with lower overall severity in children than in adults. In this review, we aimed to compare the innate and adaptive immune responses induced by RSV and SARS-CoV-2 to better understand differences in the pathogenesis of infection. Some studies have demonstrated that children present a more robust immune response against SARS-CoV-2 than adults; however, this response is dissimilar to that of RSV. Each virus has a distinctive mechanism to escape the immune response. Understanding the mechanisms underlying these differences is crucial for developing effective treatments and improving the management of pediatric respiratory infections.

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Update on the treatment of multisystem inflammatory syndrome in children associated with COVID-19

Cited by 3 publications

References 68 publications

Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review

Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review

Multisystem inflammatory syndrome in adults with COVID‐19 requiring mechanical ventilation: A retrospective cohort study

Exploring the Immune Response against RSV and SARS-CoV-2 Infection in Children

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