Abstract
Background This study aimed to describe the clinical symptoms, laboratory findings, treatment, and outcomes of coronavirus disease 2019-related multisystem inflammatory syndrome in children to provide a reference for clinical practice. Methods We employed a literature search of databases such as PubMed, Web of Science, EMBASE, and Johns Hopkins University for articles on COVID-19-related multisystem inflammatory syndrome in children published between April 1, 2020, and January 15, 2021. High-quality articles were selected for analysis on the basis of their quality standard scores. Using R3.6.3 software, meta-analyses of random- or fixed-effects models were used to determine the prevalence of comorbidities. Subgroup analysis was also performed to determine heterogeneity. Results A total of 57 articles (2,290 pediatric patients) were included in the study. Clinical Manifestations. :ncidences of fever, gastrointestinal symptoms, respiratory symptoms, and musculoskeletal symptoms (myalgias or arthralgias) were 99.91% (95% CI: 99.67–100%), 82.72% (95% CI: 78.19–86.81%), 53.02% (45.28–60.68%), and 14.16% (95% CI: 8.4–21.12%), respectively. The incidences of rash, conjunctival injection, lymphadenopathy, dry cracked lips, neurologic symptoms (headache, altered mental status, or confusion), swollen hands and feet, typical Kawasaki disease, and atypical Kawasaki disease were 59.34% (95% CI: 54.73–63.87%), 55.23% (95% CI: 50.22–60.19%), 27.07% (95% CI: 19.87–34.93%), 46.37% (95% CI: 39.97–52.83%), 28.87% (95% CI: 22.76–35.40%), 28.75% (95% CI: 21.46–36.64%), 17.32% (95% CI: 15.44–19.29%), and 36.19% (95% CI: 21.90–51.86%), respectively. The incidences of coronary artery dilation, aneurysm, pericardial effusion, myocarditis, myocardial dysfunction, high troponin, and N-terminal pro-B-type natriuretic peptide were 17.83%, 6.85%, 20.97%, 35.97%, 56.32%, 76.34%, and 86.65%, respectively. The incidences of reduced lymphocytes, thrombocytopenia, hypoalbuminemia, elevated C-reactive protein, ferritin, LDH, interleukin-6, PCT, and FIB were 61.51%, 26.42%, 77.92%, 98.5%, 86.79%, 80.59%, 89.30%, 85.10%, and 87.01%, respectively. PICU Hospitalization Rate and Mortality. The incidences of PICU hospitalization or with shock were 72.79% and 55.68%, respectively. The mortality rate was 1.00%. Conclusion and Relevance. PICU hospitalization and shock rates of multisystem inflammatory syndrome in children associated with COVID-19 were high, and its cumulative multiorgans and inflammatory indicators are increased, but if treated in time, the mortality rate was low.
Highlights
Ji-Gan Wang,1 Zhi-Juan Zhong,2 Meng Li,1 Jun Fu,1 Yu-Heng Su,1 You-Min Ping,1 Zi-Ji Xu,1 Hao Li,1 Yan-Hao Chen,1 and Yu-Li Huang1
In April 2020, eight children were reported in the United Kingdom with hyperinflammatory shock, showing features similar to atypical Kawasaki disease—Kawasaki disease shock syndrome [4]. is first report was followed by more in the United States and other regions thereafter [5] and became known as “multisystem inflammatory syndrome in children” (MIS-C). e syndrome was clinically similar to Kawasaki disease (KD), as well as toxic shock syndrome and secondary lymphoid tissue cells hyperplasia/macrophage
As the disease was discovered in April as a new disease, the name and definition of the disease during the first 2 months were quite different. erefore, “pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 pandemic (PIMS-TS)” and “multisystem inflammatory syndrome in children (MIS-C)” and “SARS-CoV-2-induced Kawasaki-like hyperinflammatory syndrome (SCiKH syndrome)” were included in the analysis [8]
Summary
Ji-Gan Wang ,1 Zhi-Juan Zhong, Meng Li, Jun Fu, Yu-Heng Su, You-Min Ping, Zi-Ji Xu, Hao Li, Yan-Hao Chen, and Yu-Li Huang. As the pandemic progressed and children died, people began to pay attention to this part of the population [3]. In April 2020, eight children were reported in the United Kingdom with hyperinflammatory shock, showing features similar to atypical Kawasaki disease—Kawasaki disease shock syndrome [4]. Is first report was followed by more in the United States and other regions thereafter [5] and became known as “multisystem inflammatory syndrome in children” (MIS-C). E syndrome was clinically similar to Kawasaki disease (KD), as well as toxic shock syndrome and secondary lymphoid tissue cells hyperplasia/macrophage. Since little was known about this new syndrome, people were extremely worried due to the severity of the condition. Since little was known about this new syndrome, people were extremely worried due to the severity of the condition. erefore, a systematic description of the clinical manifestations, laboratory tests, and prognosis of this disease is necessary
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
