EC Microbiology

Introduction: The first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was first seen in China in late 2019 and has rapidly spread across the world. As per the previous reports of SARS-CoV-2 infection, it was not seen very commonly in young children. The reason for such a low number of cases could be either asymptomatic cases or mild forms of the disease in this age group. A new syndrome termed "multisystem inflammatory syndrome in children" (MIS-C) was first described in April 2020, with a probable relation to SARS-CoV-2 infection.

Aim of Work: This review aims at highlighting an overview of, and an update on, the multisystem inflammatory syndrome in children. Methodology: The review is a comprehensive research of WHO official page, Google Scholar, and PUBMED from the year 2005 to 2021.

Conclusion: A lot of knowledge has been gained about MIS-C temporally associated with COVID-19 in a very short span of time; nevertheless, there are still many uncertainties that exist. It is an unusual disease with varying severity and symptoms. The course of the disease is usually turbulent, leading to multiple organ failure and may require hospitalization in intensive care. Although an association does exist between SARS-CoV-2 and COVID-19, more serological tests and viral research need to be conducted to establish definitive evidence of COVID-19 being caused by SARS-CoV-2

keywords: Multisystem Inflammatory Syndrome in Children; Kawasaki Disease; Anticoagulants; Toxic Shock Syndrome; Immunoglobulins

1. Nakra N A., et al. “Multi-system inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: review of clinical presentation, hypothetical pathogenesis, and proposed management”. Children 7 (2020): 69.
2. World Health Organization. Responding to community spread of COVID-19: interim guidance, March 7 2020 (No. WHO/COVID-19/ Community Transmission/2020.1). World Health Organization (2020).
3. Blumfield E., et al. “Imaging findings in multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease (COVID-19)”. American Journal of Roentgenology2 (2021): 507-517.
4. Alunno A., et al. “Storm, typhoon, cyclone or hurricane in patients with COVID-19? Beware of the same storm that has a different origin”. RMD open1 (2020): e001295.
5. Channappanavar R and Perlman S. “Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology”. In Seminars in immunopathology Springer Berlin Heidelberg5 (2017): 529-539.
6. Law H K., et al. “Chemokine up-regulation in SARS-coronavirus–infected, monocyte-derived human dendritic cells”. Blood7 (2005): 2366-2374.
7. Kumar V. “Acute and chronic inflammation”. Pathologic Basis of Disease (2005): 47-86.
8. Mehta P., et al. “COVID-19: consider cytokine storm syndromes and immunosuppression”. The Lancet10229 (2020): 1033-1034.
9. Castagnoli R., et al. “Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review”. JAMA Pediatrics9 (2020): 882-889.
10. Riphagen S., et al. “Hyperinflammatory shock in children during COVID-19 pandemic”. The Lancet10237 (2020): 1607-1608.
11. Whittaker E., et al. “Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2”. The Journal of the American Medical Association3 (2020): 259-269.
12. Toubiana J., et al. “Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study”. British Medical Journal (2020): 369.
13. Belhadjer Z., et al. “Acute heart failure in multisystem inflammatory syndrome in children in the context of global SARS-CoV-2 pandemic”. Circulation5 (2020): 429-436.
14. Simon H., et al. “Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician’s point of view☆”. Jornal de Pediatria 97 (2021): 140-159.
15. McCrindle B W., et al. “Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association”. Circulation17 (2017): e927-e999.
16. Chuang Y Y., et al. “Toxic shock syndrome in children”. Pediatric Drugs1 (2005): 11-24. https://pubmed.ncbi.nlm.nih.gov/15777108/
17. Henderson L A., et al. “On the alert for cytokine storm: immunopathology in COVID‐19”. Arthritis and Rheumatology7 (2020): 1059-1063.
18. Chesshyre E., et al. “Hemophagocytic lymphohistiocytosis and infections: An update”. The Pediatric Infectious Disease Journal3 (2019): e54-e56.
19. McGonagle D., et al. “The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease”. Autoimmunity Reviews6 (2020): 102537.
20. Assessment RR. “Paediatric Inflammatory Multisystem Syndrome and SARS-CoV-2 Infection in Children (2020).
21. Radia T., et al. “Multi-system inflammatory syndrome in children and adolescents (MIS-C): A systematic review of clinical features and presentation”. Paediatric Respiratory Reviews (2020).
22. Cancio M., et al. “Emerging trends in COVID-19 treatment: learning from inflammatory conditions associated with cellular therapies”. Cytotherapy (2020).
23. Wang Y., et al. “Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial”. The Lancet10236 (2020): 1569-1578.
24. Beigel J H., et al. “Remdesivir for the treatment of Covid-19-preliminary report”. New England Journal of Medicine (2020).
25. Tang N., et al. “Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy”. Journal of Thrombosis and Haemostasis5 (2020): 1094-1099.