Junior, Hany Simon
Sakano, Tania Miyuki Shimoda
Rodrigues, Regina Maria
Eisencraft, Adriana Pasmanik
Carvalho, Vitor Emanoel Lemos de
Schvartsman, Claudio
Reis, Amelia Gorete Afonso da Costa
2020-09-18T01:30:25Z
2020-09-18T01:30:25Z
2020-09-11
0021-7557
https://www.sciencedirect.com/science/article/pii/S0021755720302035?via%3Dihub
http://hdl.handle.net/20.500.12010/13417
20 páginas
application/pdf
eng
Jornal de Pediatria
reponame:Expeditio Repositorio Institucional UJTL
instname:Universidad de Bogotá Jorge Tadeo Lozano
COVID-19
Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician's point of view
Artículo
Síndrome respiratorio agudo grave
COVID-19
SARS-CoV-2
Coronavirus
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/acceptedVersion
Abierto (Texto Completo)
Coronavirus disease (COVID-19)
Emergency department
Inflammatory syndrome
Kawasaki disease
Pediatrics
SARS-CoV-2
https://doi.org/10.1016/j.jped.2020.08.004
Objective
Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease (COVID-19) is a rare and challenging diagnosis requiring early treatment. The diagnostic criteria involve clinical, laboratory, and complementary tests. This review aims to draw pediatrician attention to this diagnosis, suggesting early treatment strategies, and proposing a pediatric emergency care flowchart.
Sources
The PubMed/MEDLINE/WHO COVID-19 databases were reviewed for original and review articles, systematic reviews, meta-analyses, case series, and recommendations from medical societies and health organizations published through July 3, 2020. The reference lists of the selected articles were manually searched to identify any additional articles.
Summary of the findings
COVID-19 infection is less severe in children than in adults, but can present as MIS-C, even in patients without comorbidities. There is evidence of an exacerbated inflammatory response with potential systemic injury, and it may present with aspects similar to those of Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. MIS-C can develop weeks after COVID-19 infection, suggesting an immunomediated cause. The most frequent clinical manifestations include fever, gastrointestinal symptoms, rash, mucous membrane changes, and cardiac dysfunction. Elevated inflammatory markers, lymphopenia, and coagulopathy are common laboratory findings. Supportive treatment and early immunomodulation can control the intense inflammatory response and reduce complications and mortality.
Conclusions
MIS-C associated with COVID-19 is serious, rare, and potentially fatal. The emergency department pediatrician must recognize and treat it early using immunomodulatory strategies to reduce systemic injury. Further studies are needed to identify the disease pathogenesis and establish the most appropriate treatment.
http://purl.org/coar/resource_type/c_6501