ABSTRACT
The prevalence of multisystem inflammatory syndrome in children (MIS-C) has increased since the coronavirus disease 2019 (COVID-19) pandemic started. This study was aimed to describe clinical manifestation and outcomes of MIS-C associated with COVID-19. This systematic review and meta-analysis were conducted on all available literature until July 3rd, 2020. The screening was done by using the following keywords: ("novel coronavirus" Or COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus) and ("MIS-C" or "multisystem inflammatory" or Kawasaki). Data on gender, ethnicity, clinical presentations, need for mechanical ventilation or admission to intensive care unit (ICU), imaging, cardiac complications, and COVID-19 laboratory results were extracted to measure the pooled estimates. Out of 314 found articles, 16 articles with a total of 600 patients were included in the study, the most common presentation was fever (97%), followed by gastrointestinal symptoms (80%), and skin rashes (60%) as well as shock (55%), conjunctivitis (54%), and respiratory symptoms (39%). Less common presentations were neurologic problems (33%), and skin desquamation (30%), MIS-C was slightly more prevalent in males (53.7%) compared to females (46.3%). The findings of this meta-analysis on current evidence found that the common clinical presentations of COVID-19 associated MIS-C include a combination of fever and mucocutaneous involvements, similar to atypical Kawasaki disease, and multiple organ dysfunction. Due to the relatively higher morbidity and mortality rate, it is very important to diagnose this condition promptly.
Subject(s)
COVID-19/physiopathology , Conjunctivitis/physiopathology , Exanthema/physiopathology , Fever/physiopathology , Gastrointestinal Diseases/physiopathology , Shock/physiopathology , Systemic Inflammatory Response Syndrome/physiopathology , Abdominal Pain/physiopathology , Acute Kidney Injury/physiopathology , COVID-19/epidemiology , COVID-19/therapy , Cheilitis/physiopathology , Cough/physiopathology , Diarrhea/physiopathology , Dyspnea/physiopathology , Headache/physiopathology , Humans , Meningism/physiopathology , Myalgia/epidemiology , Prognosis , Respiration, Artificial , Sex Distribution , Systemic Inflammatory Response Syndrome/epidemiology , Systemic Inflammatory Response Syndrome/therapy , Vomiting/physiopathologyABSTRACT
Although presentation of COVID-19 in patients with immunodeficiency could be mild, it should not be missed, while early diagnosis and appropriate treatment can survive infected patients. Because even severe infections in PID patients may be presented with few symptoms and signs, this diagnosis should be considered in those immunocompromised patients who have exacerbating preexisting symptoms.
ABSTRACT
Although it is estimated that COVID-19 life-threatening conditions may be diagnosed in less than 1:1000 infected individuals below the age of 50, but the real impact of this pandemic on pediatric patients with different types of primary immunodeficiency (PID) is not elucidated. The current prospective study on a national registry of PID patients showed that with only 1.23 folds higher incidence of infections, these patients present a 10-folds higher mortality rate compared to population mainly in patients with combined immunodeficiency and immune dysregulation. Therefore, further management modalities against COVID-19 should be considered to improve the survival rate in these two PID entities using hematopoietic stem cell transplantation and immunomodulatory agents.
Subject(s)
COVID-19/complications , COVID-19/epidemiology , Health Impact Assessment , Primary Immunodeficiency Diseases/complications , Primary Immunodeficiency Diseases/epidemiology , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/virology , Child, Preschool , Clinical Decision-Making , Comorbidity , Disease Management , Female , Humans , Infant , Male , Mortality , Primary Immunodeficiency Diseases/diagnosis , Public Health Surveillance , Severity of Illness IndexABSTRACT
BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus 2 has affected millions of people, and especially in adult patients with underlying diseases lead to death. Meanwhile pediatric patients with inherited defects of T cell should be prone to viral diseases. CASE PRESENTATION: Herein, we report an infant with severe combined immunodeficiencies, who were affected and died because of COVID-19. CONCLUSION: Considering the importance of finding how immune system can affect the viral infection, presentation of COVID-19 in immune deficient patients can be valuable.
Subject(s)
COVID-19/pathology , Severe Combined Immunodeficiency/complications , Fatal Outcome , Humans , Infant, Newborn , Male , Severe Combined Immunodeficiency/virologyABSTRACT
New emerging viruses like coronavirus 2019 (COVID-19) infections are always frightening. We know little about their transmission, behaviors, clinical manifestations, and outcomes. There is no vaccine or therapeutic strategies to deal with these infections yet. In this situation, preventive measures may be promising. Hand hygiene is a very important issue in preventing viral infection; however, there are other entities that can enhance the immune response and help in infection prevention. Herein we review some measures for boosting the immune system.