Elevated risk for psychiatric outcomes in pediatric patients with Multisystem Inflammatory Syndrome (MIS-C): A review of neuroinflammatory and psychosocial stressors

Tracy Pan; Meghan E Gallo; Kirsten A Donald; Kate Webb; Kevin G Bath

doi:10.1016/j.bbih.2024.100760

Elevated risk for psychiatric outcomes in pediatric patients with Multisystem Inflammatory Syndrome (MIS-C): A review of neuroinflammatory and psychosocial stressors

Brain Behav Immun Health. 2024 Mar 18:38:100760. doi: 10.1016/j.bbih.2024.100760. eCollection 2024 Jul.

Authors

Tracy Pan^{1

2

3

4}, Meghan E Gallo^{2

4

5

6}, Kirsten A Donald^{7

3}, Kate Webb^{8

9}, Kevin G Bath^{4

5}

Affiliations

¹ Stanford University School of Medicine, Stanford, CA, USA.
² Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI 029112, USA.
³ The Neuroscience Institute, University of Cape Town, South Africa.
⁴ Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, 10032, USA.
⁵ Department of Psychiatry, Columbia University Irving Medical College, New York, NY, 10032, USA.
⁶ Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, NY, 10032, USA.
⁷ Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
⁸ Division of Paediatric Rheumatology, School of Child and Adolescent Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, 7700, South Africa.
⁹ Crick African Network, Francis Crick Institute, London, UK.

Abstract

Multisystem Inflammatory Syndrome in Children (MIS-C) is a secondary immune manifestation of COVID-19 involving multiple organ systems in the body, resulting in fever, skin rash, abdominal pain, nausea, shock, and cardiac dysfunction that often lead to hospitalization. Although many of these symptoms resolve following anti-inflammatory treatment, the long-term neurological and psychiatric sequelae of MIS-C are unknown. In this review, we will summarize two domains of the MIS-C disease course, 1) Neuroinflammation in the MIS-C brain and 2) Psychosocial disruptions resulting from stress and hospitalization. In both domains, we present existing clinical findings and hypothesize potential connections to psychiatric outcomes. This is the first review to conceptualize a holistic framework of psychiatric risk in MIS-C patients that includes neuroinflammatory and psychosocial risk factors. As cases of severe COVID-19 and MIS-C subside, it is important for clinicians to monitor outcomes in this vulnerable patient population.

Keywords: COVID-19; Coronavirus; Early life adversity; MIS-C; Multisystem inflammatory syndrome in children; PIMS-TS; Psychiatric risk.

Publication types

Review