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A systematic review of multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection

The Pediatric Infectious Disease Journal Oct 31, 2020

Kaushik A, Gupta S, Sood M, et al. - In view of the recent recognition of severe manifestations linked with coronavirus disease 2019 (COVID-19) called multisystem inflammatory syndrome in children (MIS-C), researchers here analyzed studies for this novel syndrome with the aim to attain better understanding of effective management among affected children. In bibliographic electronic databases (PubMed, EMBASE, and CINAHL) and in preprint servers (BioRxiv.org and MedRxiv.org), they identified a total of 328 articles following the Preferred Reporting Items for Systematic Reviews and Metaanalyses guidelines. Of these, 16 studies with 655 participants (3 months–20 years of age) were incorporated in the final analysis. Fever, gastrointestinal symptoms, and Kawasaki Disease-like symptoms were reported at presentation in most of the children. Most of the patients were critically ill, necessitating intensive care and immunomodulatory therapies. Forty percent were managed using inotropes; 34% were provided anin ticoagulation; and 15% required mechanical ventilation. Intravenous immunoglobulin was administered in more than two-thirds of the patients and corticosteroids in 49%. Thirty-two percent of patients had development of left ventricular dysfunction. Among patients presenting with KD-like symptoms, coronary abnormalities developed in 23% and circulatory shock in 26%. The majority of these critically ill patients recovered with low mortality.

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