Meenakshi Sachdeva1, Amit Agarwal2, Harnoor K Sra1, Monika Rana1, Pranita Pradhan1, Manvi Singh2, Shivani Saini1, Meenu Singh3. 1. Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. 2. Department of Telemedicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. 3. Advanced Pediatric Centre, and Department of Telemedicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. Correspondence to: Dr Meenu Singh, Prof Incharge, ICMR Advanced Centre for Evidence based Child Health, SAARC Telemedicine Network and Telemedicine Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh. meenusingh4@gmail.com.
Abstract
BACKGROUND: With wide clinical spectrum, multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) in children (MIS-C) is a relatively novel condition occurring weeks to months' post SARS-CoV-2 infection. The aim was to systematically review data on clinical features, laboratory parameters and therapeutics of MIS-C from India. Methods: This systematic review was done as per the PRISMA guidelines, and quality assessment was done using NIH tool for case-series. A systematic search through databases yielded studies whose data was pooled to calculate the mean frequencies with standard deviation using GraphPad software. RESULTS: Screening of 2548 articles published till December, 2021, yielded 11 case-series. World Health Organization case definition was used widely. There was a slight preponderance of males (57%), median (IQR) age was 7 (6,7) years, 63% (n=305) required intensive care unit admissions, and mortality rate was 10% (n=261). Clinical features included fever, mucocutaneous features (72%), and gastrointestinal problems (62%) in majority. Widely used treatment was corticosteroids (76%) and intravenous immunoglobulin (62%) with other options depending on patient's state. An increased level of inflammatory markers and derangement in other parameters corroborated with disease status. Kawasaki disease like features, not reported in many studies, ranged from 4-76% of patients. CONCLUSION: MIS-C presents with a wide spectrum clinical features, increased inflammatory markers and managed as per the disease course and presentation. Future studies monitoring the long-term effects of MIS-C are recommended.
BACKGROUND: With wide clinical spectrum, multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) in children (MIS-C) is a relatively novel condition occurring weeks to months' post SARS-CoV-2 infection. The aim was to systematically review data on clinical features, laboratory parameters and therapeutics of MIS-C from India. Methods: This systematic review was done as per the PRISMA guidelines, and quality assessment was done using NIH tool for case-series. A systematic search through databases yielded studies whose data was pooled to calculate the mean frequencies with standard deviation using GraphPad software. RESULTS: Screening of 2548 articles published till December, 2021, yielded 11 case-series. World Health Organization case definition was used widely. There was a slight preponderance of males (57%), median (IQR) age was 7 (6,7) years, 63% (n=305) required intensive care unit admissions, and mortality rate was 10% (n=261). Clinical features included fever, mucocutaneous features (72%), and gastrointestinal problems (62%) in majority. Widely used treatment was corticosteroids (76%) and intravenous immunoglobulin (62%) with other options depending on patient's state. An increased level of inflammatory markers and derangement in other parameters corroborated with disease status. Kawasaki disease like features, not reported in many studies, ranged from 4-76% of patients. CONCLUSION: MIS-C presents with a wide spectrum clinical features, increased inflammatory markers and managed as per the disease course and presentation. Future studies monitoring the long-term effects of MIS-C are recommended.
Authors: Debjyoti Dhar; Treshita Dey; M M Samim; Hansashree Padmanabha; Aritra Chatterjee; Parvin Naznin; S R Chandra; K Mallesh; Rutul Shah; Shahyan Siddiqui; K Pratik; P Ameya; G Abhishek Journal: Pediatr Res Date: 2021-05-18 Impact factor: 3.953
Authors: Rebecca F Carlin; Avital M Fischer; Zachary Pitkowsky; Dori Abel; Taylor B Sewell; Erika Grun Landau; Steve Caddle; Laura Robbins-Milne; Alexis Boneparth; Josh D Milner; Eva W Cheung; Philip Zachariah; Melissa S Stockwell; Brett R Anderson; Mark Gorelik Journal: J Pediatr Date: 2020-10-13 Impact factor: 4.406
Authors: Mônica O Santos; Lucas C Gonçalves; Paulo A N Silva; André L E Moreira; Célia R M Ito; Fernanda A O Peixoto; Isabela J Wastowski; Lilian C Carneiro; Melissa A G Avelino Journal: J Pediatr (Rio J) Date: 2021-12-03 Impact factor: 2.990