Síndrome inflamatorio multisistémico asociado al SARS-CoV-2 en pediatría: Una revisión narrativa del diagnóstico y tratamiento

Autores/as

DOI:

https://doi.org/10.33448/rsd-v13i8.46303

Palabras clave:

COVID-19; Pediatría; Terapéutica; Síndrome de respuesta inflamatoria sistémica; Diagnóstico.

Resumen

Durante la pandemia de COVID-19, los estudios iniciales que investigaron el impacto de esta enfermedad en la población pediátrica demostraron evidencia de poco impacto clínico en esta población. Sin embargo, la aparición del Síndrome Inflamatorio Multisistémico asociado al SARS-CoV-2 (SIM-P) con repercusiones sintomáticas más graves, además de mal pronóstico, hizo saltar la alarma en la comunidad pediátrica a favor de desarrollar un consenso diagnóstico y terapéutico respecto a la nuevo síndrome. Dada la relevancia del tema, este estudio propone visitar artículos de revisión, guías, metanálisis y estudios clínicos con el objetivo de discutir las mejores definiciones sobre la condición multisistémica, así como su manejo. Mediante búsqueda manual en bases de datos indexadas a Pubmed, con los siguientes descriptores: “MISC asociados a COVID-19” y “tratamiento” en inglés. Al ser buscados ambos con el booleano “AND”, se eligieron definitivamente 29 artículos. Al darnos cuenta de la urgente necesidad de definir qué sería el SIM-P, así como guiar el diagnóstico y tratamiento de los casos, utilizamos los mejores criterios para definir esta nueva condición clínica. Además, esta revisión narrativa pretende contribuir al estudio del SIM-P asociado al SARS-CoV-2 a través de un análisis crítico de la literatura, destacando el consenso sobre su diagnóstico y tratamiento.

Citas

Albanji, M. H., Baghafar, A. A., Alghanmi, Y. A., Shaaban, M. M., Alkashlan, E. A., Sende, H. H., Alzahrani, M. S., & Filfilan, N. N. (2023). Clinical Presentation and Management of Multisystem Inflammatory Syndrome in Children With COVID-19: A Systematic Review. Curēus. https://doi.org/10.7759/cureus.46918

Algarni, A. S., Alamri, N. M., Khayat, N. Z., Alabdali, R. A., Alsubhi, R. S., & Alghamdi, S. H. (2022). Clinical practice guidelines in multisystem inflammatory syndrome (MIS-C) related to COVID-19: a critical review and recommendations. World Journal of Pediatrics, 18(2), 83–90. https://doi.org/10.1007/s12519-021-00499-w

Aronoff, S. C., Hall, A., & Del Vecchio, M. T. (2020). The Natural History of Severe Acute Respiratory Syndrome Coronavirus 2–Related Multisystem Inflammatory Syndrome in Children: A Systematic Review. Journal of the Pediatric Infectious Diseases Society. https://doi.org/10.1093/jpids/piaa112

Barrera Castro, M. E., Flores Montesinos, C. E., & Barrera Castro, A. R. (2023). Afectación cardiaca por Síndrome Inflamatorio Multisistémico asociado A SARS-CoV-2 en pacientes pediátricos. Vive (El Alto), 162–171. https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1442269

Blatz, A. M., & Randolph, A. G. (2022). Severe COVID-19 and MIS-C In Children & Adolescents. Critical Care Clinics. https://doi.org/10.1016/j.ccc.2022.01.005

Bohn, M. K., Yousef, P., Steele, S., Sepiashvili, L., & Adeli, K. (2021). MultiInflammatory Syndrome in Children: A View into Immune Pathogenesis from a Laboratory Perspective. The Journal of Applied Laboratory Medicine, 7(1), 311–321. https://doi.org/10.1093/jalm/jfab114

Cannon, L., M. Jay Campbell, & Wu, E. Y. (2023). Multisystem Inflammatory Syndrome in Children and Kawasaki Disease: Parallels in Pathogenesis and Treatment. Current Allergy and Asthma Reports, 23(6), 341–350. https://doi.org/10.1007/s11882-023-01083-0

Dhar, D., Dey, T., Samim, M. M., Padmanabha, H., Chatterjee, A., Naznin, P., Chandra, S. R., Mallesh, K., Shah, R., Siddiqui, S., Pratik, K., Ameya, P., & Abhishek, G. (2022). Systemic inflammatory syndrome in COVID-19–SISCoV study: systematic review and meta-analysis. Pediatric Research, 91(6), 1334–1349. https://doi.org/10.1038/s41390-021-01545-z

Edinoff, A. N., Edward Sanders Alpaugh, Newgaard, O., Irza Wajid, Klapper, R. J., Cornett, E. M., Kaye, A. M., Iyer, P., & Kaye, A. D. (2023). Tocilizumab for Severe COVID-19 Infection and Multisystem Inflammatory Syndrome in Adults and Children. 13(4), 889–889. https://doi.org/10.3390/life13040889

Emeksiz, S., Çelikel Acar, B., Kibar, A. E., Özkaya Parlakay, A., Perk, O., Bayhan, G. İ., Cinel, G., Özbek, N., Azılı, M. N., Çelikel, E., Akça, H., Dibek Mısırlıoğlu, E., Bayrakçı, U. S., Çetin, İ. İ., Neşe Çıtak Kurt, A., Boyraz, M., Hızlı, Ş., & Şenel, E. (2021). Algorithm for the diagnosis and management of the multisystem inflammatory syndrome in children associated with COVID‐19. International Journal of Clinical Practice. https://doi.org/10.1111/ijcp.14471

Estrada-Luna, D., Carreón-Torres, E., González-Reyes, S., Martínez-Salazar, M. F., Ortiz-Rodríguez, M. A., Ramírez-Moreno, E., Arias-Rico, J., & Jiménez-Osorio, A. S. (2022). Nutraceuticals for Complementary Treatment of Multisystem Inflammatory Syndrome in Children: A Perspective from Their Use in COVID-19. Life, 12(10), 1652. https://doi.org/10.3390/life12101652

Folga, B. A., Karpenko, C. J., & Grygiel-Górniak, B. (2022). SARS-CoV-2 infection in the context of Kawasaki disease and multisystem inflammatory syndrome in children. Medical Microbiology and Immunology. https://doi.org/10.1007/s00430-022-00756-3

Fremed, M. A., & Farooqi, K. M. (2022). Longitudinal Outcomes and Monitoring of Patients With Multisystem Inflammatory Syndrome in Children. Frontiers in Pediatrics, 10. https://doi.org/10.3389/fped.2022.820229

Junior, H. S., Sakano, T. M. S., Rodrigues, R. M., Eisencraft, A. P., Carvalho, V. E. L. de, Schvartsman, C., & Reis, A. G. A. da C. (2020). Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician’s point of view. Jornal de Pediatria. https://doi.org/10.1016/j.jped.2020.08.004

Hançerli Törün, S., Yilmaz Çiftdoğan, D., & Kara, A. (2021). Multisystem inflammatory syndrome in childre. Turkish Journal of Medical Sciences, 51(SI-1), 3273–3283. https://doi.org/10.3906/sag-2105-342

Harahsheh, A. S., Portman, M. A., Khoury, M., Elias, M. D., Lee, S., Lin, J., & McCrindle, B. W. (2023). Management of Multisystem Inflammatory Syndrome in Children: Decision-Making Regarding a New Condition in the Absence of Clinical Trial Data. Canadian Journal of Cardiology, 39(6), 803–814. https://doi.org/10.1016/j.cjca.2022.11.011

Henderson, L. A., Canna, S. W., Friedman, K. G., Gorelik, M., Lapidus, S. K., Bassiri, H., Behrens, E. M., Ferris, A., Kernan, K. F., Schulert, G. S., Seo, P., Son, M. B. F., Tremoulet, A. H., Yeung, R. S. M., Mudano, A. S., Turner, A. S., Karp, D. R., & Mehta, J. J. (2021). American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS–CoV‐2 and Hyperinflammation in Pediatric COVID‐19: Version 2. Arthritis & Rheumatology, 73(4). https://doi.org/10.1002/art.41616

Hoste, L., Van Paemel, R., & Haerynck, F. (2021). Multisystem inflammatory syndrome in children related to COVID-19: a systematic review. European Journal of Pediatrics, 180(7), 2019–2034. https://doi.org/10.1007/s00431-021-03993-5

Kabeerdoss, J., Pilania, R. K., Karkhele, R., Kumar, T. S., Danda, D., & Singh, S. (2020). Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management. Rheumatology International, 41(1), 19–32. https://doi.org/10.1007/s00296-020-04749-4

Kumar, R., Rivkin, M. J., & Raffini, L. (2023). Thrombotic complications in children with Coronavirus disease 2019 and Multisystem Inflammatory Syndrome of Childhood. Journal of Thrombosis and Haemostasis, 21(9), 2313–2326. https://doi.org/10.1016/j.jtha.2023.05.020

Lee, K. H., Li, H., Lee, M. H., Park, S. J., Kim, J. S., Han, Y. J., Cho, K., Ha, B., Kim, S. J., Jacob, L., Koyanagi, A., Shin, J. I., Kim, J. H., & Smith, L. (2022). Clinical characteristics and treatments of multi-system inflammatory syndrome in children: a systematic review. DOAJ (DOAJ: Directory of Open Access Journals), 26(9), 3342–3350. https://doi.org/10.26355/eurrev_202205_28754

Long, F., Zhu, S., Wang, Z., Zhang, S., He, J., Ge, X., & Ning, J. (2023). Update on the treatment of multisystem inflammatory syndrome in children associated with COVID-19. Future Virology, 18(1), 63–74. https://doi.org/10.2217/fvl-2022-0048

McMurray, J. C., May, J. W., Cunningham, M. W., & Jones, O. Y. (2020). Multisystem Inflammatory Syndrome in Children (MIS-C), a Post-viral Myocarditis and Systemic Vasculitis-A Critical Review of Its Pathogenesis and Treatment. Frontiers in Pediatrics, 8, 626182. https://doi.org/10.3389/fped.2020.626182

Mendes, C. (2022). O que é revisão narrativa de literatura: Exemplos e considerações da metodologia. Www.youtube.com. https://www.youtube.com/watch?v=YlBWSVsxvRM

Molloy, E. J., Nakra, N., Gale, C., Dimitriades, V. R., & Lakshminrusimha, S. (2022). Multisystem inflammatory syndrome in children (MIS-C) and neonates (MIS-N) associated with COVID-19: optimizing definition and management. Pediatric Research. https://doi.org/10.1038/s41390-022-02263-w

Mota de Sousa, L. M., Furtado Firmino, C., Alves Marques-Vieira, C. M., Silva Pedro Severino, S., & Castelão Figueira Carlos Pestana, H. (2018). Revisões da literatura científica: tipos, métodos e aplicações em enfermagem. Revista Portuguesa de Enfermagem de Reabilitação, 1(1), 45–55. https://doi.org/10.33194/rper.2018.v1.n1.07.4391

Patel, J. M. (2022). Multisystem Inflammatory Syndrome in Children (MIS-C). Current Allergy and Asthma Reports. https://doi.org/10.1007/s11882-022-01031-4

Radia, T., Williams, N., Agrawal, P., Harman, K., Weale, J., Cook, J., & Gupta, A. (2020). Multi-system inflammatory syndrome in children & adolescents (MIS-C): A systematic review of clinical features and presentation. Paediatric Respiratory Reviews, 38. https://doi.org/10.1016/j.prrv.2020.08.001

Roberts, J. E., & Henderson, L. A. (2021). Clinical features of multisystem inflammatory syndrome in children. Current Opinion in Rheumatology, Publish Ahead of Print. https://doi.org/10.1097/bor.0000000000000818

Santos, M. O., Gonçalves, L. C., Silva, P. A. N., Moreira, A. L. E., Ito, C. R. M., Peixoto, F. A. O., Wastowski, I. J., Carneiro, L. C., & Avelino, M. A. G. (2021). Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes. Jornal de Pediatria. https://doi.org/10.1016/j.jped.2021.08.006

Shati, A. A., Mahmood, S. E., Alsuheel Asseri, A., Alhanshani, A. A., Alqahtani, Y. A., & Ahmad, A. (2023). SARS-CoV-2 infections and MIS-C among children: A narrative review. Medicine, 102(31), e34475. https://doi.org/10.1097/MD.0000000000034475

Publicado

04/08/2024

Cómo citar

DOURADO SEGUNDO, N. L. . Síndrome inflamatorio multisistémico asociado al SARS-CoV-2 en pediatría: Una revisión narrativa del diagnóstico y tratamiento . Research, Society and Development, [S. l.], v. 13, n. 8, p. e1313846303, 2024. DOI: 10.33448/rsd-v13i8.46303. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/46303. Acesso em: 6 sep. 2024.

Número

Sección

Ciencias de la salud