Question: What is a multisystem inflammatory syndrome (MIS?

Answer: Most children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection had mild COVID-19 infection that did not warrant the need for medical intervention. However, a cluster of previously healthy children presenting with cardiovascular shock, fever, and hyperinflammation was reported in May 2020. This hyperinflammatory syndrome is known as MIS,a syndrome with various clinical presentations and a lack of pathognomonic findings or diagnostic tests.

Question: What are the presenting symptoms of MIS in children?

Answer: Many pediatric patients with MIS have had a fever and mucocutaneous symptomscomparable to those of Kawasakis disease (a rare vasculitis of childhood that can trigger coronaryartery aneurysms). Some patients presented with features of toxic shock syndrome, secondary hemophagocytic lymphohistiocytosis, or macrophage activation syndrome.

Question: Which age group dies MIS affect?

Answer: MIS in children has been suggested to predominantly affect adolescents and children older than fiveyears of age.

Question: What is the management of MIS-C?

Answer: An understanding of the pathogenesis of MIS-C will be essential to inform clinical management and prevention efforts. A preponderance of patients was treated with immunomodulatory drugs, primarily intravenous immune globulin and systemic glucocorticoids. However, whether organ damage is mediated by ongoing viral replication in the affected tissues and aggravated host inflammatory response, or both, the choice of candidate treatment methods must be advised. Antiviral agents may be helpful in the case of ongoing replication, whereas immunomodulatory agents for immune dysregulation.

Reference

Feldstein LR, Rose EB, Horwitz SM, Collins JP, et al. Multisystem inflammatory syndrome in US children and adolescents. N Engl K Med. 2020; 383: 334-346.