Multisystem Inflammatory Syndrome in Children (MIS-C) is a new phenomenon reported worldwide with temporal association with COVID-19.

A new study published in Pediatric Respiratory Reviews evaluated reported cases of MIS-C in children and adolescents.

This was a systematic review of clinical features and presentation from 1 726 papers – 35 documented papers related to MIS-C cases that identified 783 individual cases of MIS-C between March-June 2020. Among the patients, 55% were males at the median age of 8.6 years—age-range—3months to 20 years.

The findings showed that patients with MIS-C had a high frequency of gastrointestinal symptoms (71%) – including abdominal pain in 34% and diarrhea in 27%. While cough and respiratory distress were reported in 4.5% and 9.6% cases, respectively. Blood parameters showed neutrophilia in 345/418 (83%) of cases and a high CRP in 587/626 (94%). Meanwhile, 362/619 (59%) cases were SARS-CoV-2 infection positive (serology or PCR), but only 41% demonstrated pulmonary changes on chest imaging. However, the severity of illness was high with 68% cases requiring intensive care admission; 63% requiring inotropic support; 244/783 (28%) needing some form of respiratory support (138 mechanically ventilated); and 31 required extra-corporeal membrane oxygenation. Treatment strategies included intravenous immunoglobulin (63%) and intravenous steroids (44%); 29 cases received Infliximab, 47 received IL1 (interleukin) receptor antagonist and 47 received IL6-receptor antagonist. Unfortunately, 12/783 (1.5%) children died.

Therefore, a higher incidence of gastrointestinal symptoms were noted in MIS-C. In contrast to acute COVID-19 infection in children, MIS-C appears to be a condition of higher severity with 68% of cases having required critical care support.

Source: Pediatric Respiratory Reviews. 2020 Aug 11;S1526-0542(20)30117-2. doi: 10.1016/j.prrv.2020.08.001.