Pediatric Multisystemic Inflammatory Syndrome (MIS-P) temporarily associated with COVID-19: a survey of clinical and epidemiological characteristics
DOI:
https://doi.org/10.33448/rsd-v10i3.13020Keywords:
Coronavirus infections; Inflammation; Pediatrics.Abstract
The aim of the present study was to analyze the current scientific literature regarding Pediatric Multisystemic Inflammatory Syndrome (SIM-P) temporarily associated with COVID-19, in order to document the main findings and their therapeutic management. A systematic review of studies was carried out in the databases US National Library of Medicine (PubMed), Scientific Electronic Library Online (Scielo) and ScienceDirect, from September 2020 to February 2021, using the descriptors multisystem inflammatory syndrome, children and COVID-19. The included articles presented observational studies with patients diagnosed with SIM-P, original articles and meta-analyzes published between the years 2020 and 2021. Studies that did not sufficiently describe the data, which were not related to the objective of this review, as well as news, comments, cover letters and duplicates of articles were excluded. Of the 668 studies found, 27 comprised this review. SIM-P affects children and adolescents between 0 and 19 years old, with persistent fever, gastrointestinal symptoms, shortness of breath, abdominal pain and organ dysfunctions. This syndrome is a delayed inflammatory immune response to recent SARS-CoV-2 infection, showing changes in inflammatory markers and other indicators, associated with changes in imaging tests. Therapeutic management aims to reduce the systemic inflammatory response and reestablish organic functions using immunoglobulin, corticosteroids, vasoactive drugs, immunomodulators and anticoagulants. Little scientific evidence is available to understand this syndrome. Thus, multicenter and prospective studies are necessary to better understand the pathophysiology, diagnostic criteria, treatment and existence of medium to long term complications.
References
Adeyinka, A., Bailey, K., Pierre, L., & Kondamudi, N. (2021). COVID 19 infection: Pediatric perspectives. Journal of the American College of Emergency Physicians open, 2(1), e12375.
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. (2020). Multisystem inflammatory syndrome in children: A systematic review. EClinicalMedicine, 26, 100527.
Alunno, A., Carubbi, F., & Rodríguez-Carrio, J. (2020). Storm, typhoon, cyclone or hurricane in patients with COVID-19? Beware of the same storm that has a different origin. RMD open, 6(1), e001295.
Belhadjer, Z., Méot, M., Bajolle, F., Khraiche, D., Legendre, A., Abakka, S., Auriau, J., Grimaud, M., Oualha, M., Beghetti, M., Wacker, J., Ovaert, C., Hascoet, S., Selegny, M., Malekzadeh-Milani, S., Maltret, A., Bosser, G., Giroux, N., Bonnemains, L., Bordet, J., … Bonnet, D. (2020). Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic. Circulation, 142(5), 429–436.
Beroukhim, R. S., & Friedman, K. G. (2020). Children at Risk: Multisystem Inflammatory Syndrome and COVID-19. JACC. Case reports, 2(9), 1271–1274.
Calvo, C., López-Hortelano, M. G., Vicente, J. C. D. C., & Martínez, J. L. V. (2020). Recommendations on the clinical management of the COVID-19 infection by the «new coronavirus» SARS-CoV2. Spanish Paediatric Association working group. An Pediatr (Engl Ed), 92 (4), 241.e1–241.e11.
Campos, L. R., Cardoso, T. M., Martinez, J. C. F. F., Almeida, R. G., Silva, R. M., Fonseca, A. R., Sztajnbok, F.R. (2020). Pediatric inflammatory multisystem syndrome (PIMS) temporally related to SARS-CoV-2. Resid Pediatr, 10(2):1-6.
Consiglio, C. R., Cotugno, N., Sardh, F., Pou, C., Amodio, D., Rodriguez, L., Tan, Z., Zicari, S., Ruggiero, A., Pascucci, G. R., Santilli, V., Campbell, T., Bryceson, Y., Eriksson, D., Wang, J., Marchesi, A., Lakshmikanth, T., Campana, A., Villani, A., Rossi, P., Brodin, P. (2020). The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19. Cell, 183(4), 968–981.e7.
Diorio, C., Henrickson, S. E., Vella, L. A., McNerney, K. O., Chase, J., Burudpakdee, C., Lee, J. H., Jasen, C., Balamuth, F., Barrett, D. M., Banwell, B. L., Bernt, K. M., Blatz, A. M., Chiotos, K., Fisher, B. T., Fitzgerald, J. C., Gerber, J. S., Gollomp, K., Gray, C., Grupp, S. A., Bassiri, H. (2020). Multisystem inflammatory syndrome in children and COVID-19 are distinct presentations of SARS-CoV-2. The Journal of clinical investigation, 130(11), 5967–5975.
Dove M. L., Jaggi P, Kelleman M, Abuali M, Ang JY, Ballan W, Basu S. K., Campbell M. J., Chikkabyrappa S. M., Choueiter N. F., Clouser K. N., Corwin, D., Edwards, A., Gertz, S. J., Ghassemzadeh, R., Jarrah, R. J., Katz, S. E., Knutson, S. M., Kuebler, J. D., Lighter, J., Mikesell, C., Mongkolrattanothai, K., Morton, T., Nakra, N. A., Olivero, R., Osborne, C. M., Panesar, L. E., Parsons, S., Patel, R. M., Schuette, J., Thacker, D., Tremoulet, A. H., Vidwan, N. K., Oster, M. E. (2020). Multisystem Inflammatory Syndrome in Children: Survey of Protocols for Early Hospital Evaluation and Management. J Pediatr. 2021 Feb;229:33-40.
Dufort, E. M., Koumans, E. H., Chow, E. J., Rosenthal, E. M., Muse, A., Rowlands, J., Barranco, M. A., Maxted, A. M., Rosenberg, E. S., Easton, D., Udo, T., Kumar, J., Pulver, W., Smith, L., Hutton, B., Blog, D., Zucker, H. New York State and Centers for Disease Control and Prevention Multisystem Inflammatory Syndrome in Children Investigation Team. (2020) Multisystem Inflammatory Syndrome in Children in New York State. N Engl J Med. 2020 Jul 23;383(4):347-358.
Eastin, C., & Eastin, T. (2020). Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. The Journal of Emergency Medicine, 58(4), 712–713.
Elias, M. D., McCrindle, B. W., Larios, G., Choueiter, N. F., Dahdah, N., Harahsheh, A. S., Jain, S., Manlhiot, C., Portman, M. A., Raghuveer, G., Giglia, T. M., Dionne, A., & of the International Kawasaki Disease Registry. (2020). Management of Multisystem Inflammatory Syndrome in Children Associated With COVID-19: A Survey From the International Kawasaki Disease Registry. CJC open, 2(6), 632–640.
Esposito, S., & Principi, N. (2021). Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2. Paediatric drugs, 1–11. Advance online publication.
Feldstein, L. R., Rose, E. B., Horwitz, S. M., Collins, J. P., Newhams, M. M., Son, M., Newburger, J. W., Kleinman, L. C., Heidemann, S. M., Martin, A. A., Singh, A. R., Li, S., Tarquinio, K. M., Jaggi, P., Oster, M. E., Zackai, S. P., Gillen, J., Ratner, A. J., Walsh, R. F., Fitzgerald, J. C., CDC COVID-19 Response Team (2020). Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. The New England journal of medicine, 383(4), 334–346.
Guo, Y. R., Cao, Q. D., Hong, Z. S., Tan, Y. Y., Chen, S. D., Jin, H. J., Tan, K. S., Wang, D. Y., & Yan, Y. (2020). The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Military Medical Research, 7(1), 11.
Hoang, A., Chorath, K., Moreira, A., Evans, M., Burmeister-Morton, F., Burmeister F, Naqvi, R., Petershack, M & Moreira A. (2020). COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine, 24, 100433.
Hong, H., Wang, Y., Chung, H., & Chen, C. (2020). Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children. Pediatr Neonatol, 61 (2), 131–132.
Jiang, L., Tang, K., Levin, M., Irfan, O., Morris, S. K., Wilson, K. (2020). COVID-19 and multisystem inflammatory syndrome in children and adolescentes. The Lancet Infectious Diseases, 20(11), e276 - e288.
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ, 339, b2700.
Ministério da Saúde, Secretaria de Vigilância em Saúde. (2021). Boletim epidemiológico. 52(03), 1-31.
Pereira A. S., Shitsuka, D. M., Parreira, F. J., Shitsuka, R. (2018). Metodologia da pesquisa científica. In Colusso, P. R., Construção e validação de instrumentos e técnicas de coleta de dados (pp. 42-43). Santa Maria: UFSM, NTE.
Prata-Barbosa, A., Lima-Setta, F., Santos, G. R. D., Lanziotti, V. S., de Castro, R. E. V., de Souza, D. C., Raymundo, C. E., de Oliveira, F. R. C., de Lima, L. F. P., Tonial, C. T., Colleti, J. Jr., Bellinat, A. P. N., Lorenzo, V. B., Zeitel, R. S., Pulcheri, L., Costa, F. C. M. D., La Torre, F. P. F., Figueiredo, E. A. D. N, Silva, T. P. D., Riveiro, P. M., Mota, I. C. F. D., Brandão, I. B., de Azevedo, Z. M. A., Gregory, S. C., Boedo, F. R. O., de Carvalho, R. N., Castro, N. A. A. S. R., Genu, D. H. S., Foronda, F. A.K., Cunha, A. J. L. A., de Magalhães-Barbosa, M. C., Brazilian Research Network in Pediatric Intensive Care, (BRnet-PIC). (2020). Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study. J Pediatr (Rio J), 96(5), 582-592.
Qiu, H., Wu, J., Hong, L., Luo, Y., Song, Q., Chen, D. (2020). Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. The Lancet Infectious Diseases, 20(6), 689-696.
Safadi M. (2020). The intriguing features of COVID-19 in children and its impact on the pandemic. Jornal de pediatria, 96(3), 265–268.
Sarzi-Puttini, P., Giorgi, V., Sirotti, S., Marotto, D., Ardizzone, S., Rizzardini, G., Antinori, S., & Galli, M. (2020). COVID-19, cytokines and immunosuppression: what can we learn from severe acute respiratory syndrome?. Clinical and experimental rheumatology, 38(2), 337–342.
Shah, S. K., & Munoz, A. C. (2020). Multisystem Inflammatory Syndrome in Children in COVID-19 Pandemic. Indian journal of pediatrics, 87(9), 671–673.
Simon Junior, H., Sakano, T., Rodrigues, R. M., Eisencraft, A. P., Carvalho, V., Schvartsman, C., & Reis, A. (2020). Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician's point of view. Jornal de pediatria, S0021-7557(20)30203-5.
Song, Y., Liu, P., Shi, X. L., Chu, Y. L., Zhang, J., Xia, J., Gao, X. Z., Qu, T., & Wang, M. Y. (2020). SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19. Gut, 69(6), 1143–1144.
Toubiana, J., Poirault, C., Corsia, A., Bajolle, F., Fourgeaud, J., Angoulvant, F., Debray, A., Basmaci, R., Salvador, E., Biscardi, S., Frange, P., Chalumeau, M., Casanova, J. L., Cohen, J. F., & Allali, S. (2020). Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ (Clinical research ed.), 369, m2094.
Viner, R. M., & Whittaker, E. (2020). Kawasaki-like disease: emerging complication during the COVID-19 pandemic. Lancet (London, England), 395(10239), 1741–1743.
Whittaker, E., Bamford, A., Kenny, J., Kaforou, M., Jones, C. E., Shah, P., Ramnarayan, P., Fraisse, A., Miller, O., Davies, P., Kucera, F., Brierley, J., McDougall, M., Carter, M., Tremoulet, A., Shimizu, C., Herberg, J., Burns, J. C., Lyall, H., Levin, M., … PIMS-TS Study Group and EUCLIDS and PERFORM Consortia (2020). Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA, 324(3), 259–269.
Winant, A. J., Blumfield, E., Liszewski, M. C., Kurian, J., Foust, A., & Lee, E. Y. (2020). Thoracic Imaging Findings of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: What Radiologists Need to Know Now. Radiology. Cardiothoracic Imaging, 2(4), e200346.
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Copyright (c) 2021 Bruno Wesley Ramalho Cirilo Ferreira; Anaís Bezerra de Gusmão; Pollyana Amorim Ponce de Leon; Rossana Karla Gois Ferreira; Cibério Landim Macedo
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