Pediatric Inflammatory Multisystem Syndrome Associated With SARS-CoV-2: A Case Series Quantitative Systematic Review

Pediatr Emerg Care. 2021 Jan 1;37(1):44-47. doi: 10.1097/PEC.0000000000002306.

Abstract

Pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS) is infrequent, but children might present as a life-threatening disease. In a systematic quantitative review, we analyzed 11 studies of PIMS-TS, including 468 children reported before July 1, 2020. We found a myriad of clinical features, but we were able to describe common characteristics: previously healthy school-aged children, persistent fever and gastrointestinal symptoms, lymphopenia, and high inflammatory markers. Clinical syndromes such as myocarditis and Kawasaki disease were present in only one third of cases each one. Pediatric intensive care unit admission was frequent, although length of stay was less than 1 week, and mortality was low. Most patients received immunoglobulin or steroids, although the level of evidence for that treatment is low. The PIMS-ST was recently described, and the detailed quantitative pooled data will increase clinicians' awareness, improve diagnosis, and promptly start treatment. This analysis also highlights the necessity of future collaborative studies, given the heterogeneous nature of the PIMS-TS.

Publication types

  • Systematic Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • COVID-19 / etiology
  • COVID-19 / therapy
  • COVID-19 Drug Treatment
  • Child
  • Combined Modality Therapy
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Intensive Care Units, Pediatric / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Mucocutaneous Lymph Node Syndrome / epidemiology
  • Mucocutaneous Lymph Node Syndrome / etiology
  • Myocarditis / epidemiology
  • Myocarditis / etiology
  • SARS-CoV-2*
  • Systemic Inflammatory Response Syndrome / drug therapy
  • Systemic Inflammatory Response Syndrome / epidemiology
  • Systemic Inflammatory Response Syndrome / etiology*

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Anticoagulants
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related