Your browser doesn't support javascript.
SARS-CoV-2-associated multisystem inflammatory syndrome in children: clinical manifestations and the role of infliximab treatment.
Abdel-Haq, Nahed; Asmar, Basim I; Deza Leon, Maria P; McGrath, Eric J; Arora, Harbir S; Cashen, Katherine; Tilford, Bradley; Charaf Eddine, Ahmad; Sethuraman, Usha; Ang, Jocelyn Y.
  • Abdel-Haq N; Division of Infectious Diseases, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, USA. nabdel@dmc.org.
  • Asmar BI; Wayne State University, Detroit, MI, USA. nabdel@dmc.org.
  • Deza Leon MP; Central Michigan University, Mount Pleasant, MI, USA. nabdel@dmc.org.
  • McGrath EJ; Division of Infectious Diseases, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, USA.
  • Arora HS; Wayne State University, Detroit, MI, USA.
  • Cashen K; Central Michigan University, Mount Pleasant, MI, USA.
  • Tilford B; Division of Infectious Diseases, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, USA.
  • Charaf Eddine A; Division of Infectious Diseases, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, USA.
  • Sethuraman U; Wayne State University, Detroit, MI, USA.
  • Ang JY; Division of Infectious Diseases, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201, USA.
Eur J Pediatr ; 180(5): 1581-1591, 2021 May.
Article in English | MEDLINE | ID: covidwho-1384440
ABSTRACT
This study was conducted to assess the clinical spectrum, management, and outcome of SARS-CoV-2-related multisystem inflammatory syndrome in children (MIS-C). We reviewed medical records of children with MIS-C diagnosis seen at the Children's Hospital of Michigan in Detroit between April and June 2020. Thirty-three children were identified including 22 who required critical care (group 1) and 11 with less intense inflammation (group 2). Children in group 1 were older (median 7.0 years) than those in group 2 (median 2.0 years). Abdominal pain was present in 68% of patients in group 1. Hypotension or shock was present in 17/22 patients in group 1. Thirteen (39.4%) had Kawasaki disease (KD)-like manifestations. Five developed coronary artery dilatation; All resolved on follow-up. Intravenous immunoglobulin (IVIG) was given to all patients in group 1 and 7/11 in group 2. Second-line therapy was needed in 13/22 (group 1) for persisting inflammation or myocardial dysfunction; 12 received infliximab. All patients recovered.

Conclusion:

MIS-C clinical manifestations may overlap with KD; however, MIS-C is likely a distinct inflammatory process characterized by reversible myocardial dysfunction and rarely coronary artery dilatation. Supportive care, IVIG, and second-line therapy with infliximab were associated with a favorable outcome. What is Known • Multisystem inflammatory syndrome in children (MIS-C) manifestations include fever, gastrointestinal symptoms, shock, and occasional features of Kawasaki disease (KD). • Treatment includes immunomodulatory agents, most commonly IVIG and corticosteroids. What is New • Spectrum of MIS-C varies from mild to severe inflammation and coronary artery dilatation occurred in 5/22 (23%) critically ill patients. • IVIG and infliximab therapy were associated with a favorable outcome including resolution of coronary dilatation; only 2/33 received corticosteroids.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / Infliximab / COVID-19 Drug Treatment Type of study: Cohort study / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: Eur J Pediatr Year: 2021 Document Type: Article Affiliation country: S00431-021-03935-1

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / Infliximab / COVID-19 Drug Treatment Type of study: Cohort study / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: Eur J Pediatr Year: 2021 Document Type: Article Affiliation country: S00431-021-03935-1