Marco Cattalini1,2, Andrea Taddio3,4, Alberto Villani5, Angelo Ravelli6, Claudia Bracaglia7, Rolando Cimaz8, Sara Della Paolera4, Giovanni Filocamo9, Francesco La Torre10, Bianca Lattanzi11, Alessandra Marchesi5, Gabriele Simonini12, Gianvincenzo Zuccotti13, Fiammetta Zunica14. 1. Pediatrics Clinic, University of Brescia and ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy. marco.cattalini@unibs.it. 2. University of Brescia, P.zza Del Mercato 15, Brescia, Italy. marco.cattalini@unibs.it. 3. Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy. 4. University of Trieste, Piazzale Europa 2, 34100, Trieste, Italy. 5. Bambino Gesu' Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy. 6. Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini and DINOGMI, Università di Genova, Via Gerolamo Gaslini 5, 16147, Genoa, Italy. 7. Division of Rheumatology, Bambino Gesù Children's Hospital, IRCCS, Piazza di Sant'Onofrio, 4, 00165, Rome, Italy. 8. Department of Clinical Sciences and Community Health, University of Milan, Via Commenda 19, 20122, Milan, Italy. 9. Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy. 10. Pediatric Rheumatology Center, Pediatric Unit, "Giovanni XXIII", Pediatric Hospital, Via Giovanni Amendola 207, 70126, Bari, Italy. 11. SOD Pediatria, Ospedali Riuniti, Via Conca 71, Torrette, 60126, Ancona, Italy. 12. Pediatric Rheumatology Unit, AOU Meyer, University of Florence, Via Gaetano Pieraccini 24, 50139, Florence, Italy. 13. Department of Pediatrics, Children's Hospital V Buzzi, University of Milan, Via Lodovico Castelvetro 32, 20154, Milan, Italy. 14. University of Brescia, P.zza Del Mercato 15, Brescia, Italy.
Abstract
BACKGROUND: Italy was the first Western country to be hit by the SARS-CoV-2 epidemic. There is now mounting evidence that a minority of children infected with SARS-CoV2 may experience a severe multisystem inflammatory syndrome, called Multisystem inflammatory Syndrome associated with Coronavirus Disease 2019 (MIS-C). To date no universally agreed approach is available for this disease. MAIN BODY: as Italy is now facing a second hity of COVID-19 cases, we fear a recrudescence of MIS-C cases. We have, therefore, decided to prepare a report that will help clinicians to face this novel and challenging disease. We propose a diagnostic algorithm, to help case definition and guide work-up, and a therapeutic approach. MIS-C should be promptly recognized, based on the presence of systemic inflammation and specific organ involvement. Early treatment is crucial, and it will be based on the combined use of corticosteroids, high-dose immunoglobulins and anti-cytokine treatments, depending on the severity of the disease. Ancillary treatments (such as. aspirin and thrombo-profilaxis) will be also discussed. CONCLUSIONS: we propose a document that will help physicians to diagnose and treat MIS-C patients. Given the level of evidence available and the methodology used, this document should not be interpreted as a guideline; the final decision about the optimal management should still be taken by the caring physician, on an individual basis.
BACKGROUND: Italy was the first Western country to be hit by the SARS-CoV-2 epidemic. There is now mounting evidence that a minority of childreninfected with SARS-CoV2 may experience a severe multisystem inflammatory syndrome, called Multisystem inflammatory Syndrome associated with Coronavirus Disease 2019 (MIS-C). To date no universally agreed approach is available for this disease. MAIN BODY: as Italy is now facing a second hity of COVID-19 cases, we fear a recrudescence of MIS-C cases. We have, therefore, decided to prepare a report that will help clinicians to face this novel and challenging disease. We propose a diagnostic algorithm, to help case definition and guide work-up, and a therapeutic approach. MIS-C should be promptly recognized, based on the presence of systemic inflammation and specific organ involvement. Early treatment is crucial, and it will be based on the combined use of corticosteroids, high-dose immunoglobulins and anti-cytokine treatments, depending on the severity of the disease. Ancillary treatments (such as. aspirin and thrombo-profilaxis) will be also discussed. CONCLUSIONS: we propose a document that will help physicians to diagnose and treat MIS-C patients. Given the level of evidence available and the methodology used, this document should not be interpreted as a guideline; the final decision about the optimal management should still be taken by the caring physician, on an individual basis.
Authors: Andrew Reisner; Laura S Blackwell; Iqbal Sayeed; Hannah E Myers; Bushra Wali; Stacy Heilman; Janet Figueroa; Austin Lu; Laila Hussaini; Evan J Anderson; Andi L Shane; Christina A Rostad Journal: Exp Biol Med (Maywood) Date: 2021-09-26
Authors: Jozef Klučka; Eva Klabusayová; Milan Kratochvíl; Tereza Musilová; Václav Vafek; Tamara Skříšovská; Martina Kosinová; Pavla Havránková; Petr Štourač Journal: Children (Basel) Date: 2022-04-11
Authors: G Biganzoli; D Dilillo; E Biganzoli; G Zuccotti; V Calcaterra; S Mannarino; L Fiori; G Pelizzo; E Zoia; V Fabiano; P Carlucci; A Camporesi; C Corti; G Mercurio; F Izzo Journal: J Endocrinol Invest Date: 2021-07-26 Impact factor: 4.256