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Review
. 2022 Jul-Aug;98(4):338-349.
doi: 10.1016/j.jped.2021.08.006. Epub 2021 Dec 3.

Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes

Mônica O Santos  1 , Lucas C Gonçalves  2 , Paulo A N Silva  2 , André L E Moreira  3 , Célia R M Ito  3 , Fernanda A O Peixoto  4 , Isabela J Wastowski  5 , Lilian C Carneiro  3 , Melissa A G Avelino  4
Affiliations
Review

Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes

Mônica O Santos et al. J Pediatr (Rio J). 2022 Jul-Aug.

Abstract

Objective: The clinical cases of patients with multisystem inflammatory syndrome (MIS-C) were analyzed via a systematic review and meta-analysis of the clinical findings, treatments, and possible outcomes of articles retrieved via database searches.

Sources: The authors searched the PubMed, Scielo, Web of Science, Science Direct, EMBASA, EBSCO, and Scopus databases for articles containing the keywords "multisystem inflammatory syndrome in children" or "MIS-C" or "PIMS-TS" or "SIMP" and "COVID-19" or "SARS-CoV-2" published between December 1st, 2019 and July 10th, 2021. Patient characteristics, tissue and organ comorbidities, the incidence of symptoms after COVID-19 infection, treatment, and patient evolution in the articles found were evaluated. The data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Newcastle-Ottawa Scale (NOS).

Findings: In total, 98 articles (2275 patients) were selected for demographics, clinical treatment, and outcomes of patients diagnosed with MIS-C. The average age of children with MIS-C, 56.8% of whom were male, was of nine years. Fever (100%), gastrointestinal (GI) (82%), and abdominal pain (68%) were the decisive symptoms for the diagnosis of MIS-C. Shock and/or hypotension were common in patients with MIS-C. Cardiac symptoms (66%) predominated over respiratory (39%) and neurological (28%) symptoms. MIS-C treatment followed the common guidelines for treating children with septic shock and Kawasaki disease (KD) and proved to be effective.

Conclusions: This meta-analysis highlights the main clinical symptoms used for the diagnosis of MIS-C, the differences between MIS-C and KD, and the severity of the inflammatory process and urgency for hospital care.

Keywords: COVID-19; Children; MIS-C; PIMS-TS; SARS-CoV-2.

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Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest.

Figures

Fig 1
Figure 1
PRISMA flow diagram of the search of databases. The diagram contains the steps of identification, screening, eligibility, and inclusion.
Fig 2
Figure 2
Summary of the size of the effect of proportions on all the variables studied in the meta-analysis.
See this image and copyright information in PMC

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References

    1. RCPCH. Paediatric multisystem inflammatory syndrome temporally associated with COVID- 19 (PIMS) - guidance for clinicians. 2020;178:379-85. [Cited 2020 Nov 23]. Available from:https://www.rcpch.ac.uk/resources/paediatric-multisystem-inflammatory-sy....
    1. CDC . 2020. Centers for disease control and prevention. Emergency Preparedness and Response: Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. May 14.
    1. WHO . WHO; Geneva: 2020. Organization World Health. Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535. - PMC - PubMed
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–560. - PMC - PubMed

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