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Multisystem inflammatory syndrome in children: A systematic review #MMPMID32923992
Ahmed M; Advani S; Moreira A; Zoretic S; Martinez J; Chorath K; Acosta S; Naqvi R; Burmeister-Morton F; Burmeister F; Tarriela A; Petershack M; Evans M; Hoang A; Rajasekaran K; Ahuja S; Moreira A
EClinicalMedicine 2020[Sep]; 26 (ä): 100527 PMID32923992show ga
BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 (COVID-19). We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition. METHODS: We conducted a systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C. We searched four medical databases to encompass studies characterizing MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors screened articles, extracted data, and assessed risk of bias. This review was registered with PROSPERO CRD42020191515. FINDINGS: Our search yielded 39 observational studies (n = 662 patients). While 71.0% of children (n = 470) were admitted to the intensive care unit, only 11 deaths (1.7%) were reported. Average length of hospital stay was 7.9 +/- 0.6 days. Fever (100%, n = 662), abdominal pain or diarrhea (73.7%, n = 488), and vomiting (68.3%, n = 452) were the most common clinical presentation. Serum inflammatory, coagulative, and cardiac markers were considerably abnormal. Mechanical ventilation and extracorporeal membrane oxygenation were necessary in 22.2% (n = 147) and 4.4% (n = 29) of patients, respectively. An abnormal echocardiograph was observed in 314 of 581 individuals (54.0%) with depressed ejection fraction (45.1%, n = 262 of 581) comprising the most common aberrancy. INTERPRETATION: Multisystem inflammatory syndrome is a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown. FUNDING: Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study.
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EClinicalMedicine 2020 ; 26 (ä): 100527
