Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021;26(4):318-338.
doi: 10.5863/1551-6776-26.4.318. Epub 2021 May 19.

The Trilogy of SARS-CoV-2 in Pediatrics (Part 2): Multisystem Inflammatory Syndrome in Children

Van L Tran, Sarah Parsons, Andrew Nuibe

The Trilogy of SARS-CoV-2 in Pediatrics (Part 2): Multisystem Inflammatory Syndrome in Children

Van L Tran et al. J Pediatr Pharmacol Ther. 2021.

Abstract

Multisystem Inflammatory Syndrome in Children (MIS-C) was first recognized as a novel illness in 2020 with manifestations similar to other hyperinflammatory syndromes, such as Kawasaki disease or macrophage activation syndrome. Severity varies from a self-limited febrile illness to shock requiring inotropes and mechanical ventilation. Gastrointestinal symptoms and persistent fevers are the most common clinical symptoms, with the addition of cardiac manifestations inclusive of ventricular dysfunction and coronary artery aneurysms. With no controlled trials or comparative effectiveness studies evaluating treatment of MIS-C to date, current treatment with immunomodulatory agents has mainly been derived from previous experience treating Kawasaki disease. This article provides a comprehensive review summarizing published data for the evaluation and management of MIS-C, with a focus on pharmacotherapy treatment considerations.

Keywords: MIS-C; PIM-TS; SARS-CoV-2; children; coronavirus-19; multisystem inflammatory syndrome in children; pediatric.

PubMed Disclaimer

Conflict of interest statement

Disclosure. The authors declare no conflict or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.

Figures

Figure 1.
Figure 1.
Predicted MIS-C pathophysiology.
Figure 2.
Figure 2.
Emergency Department Initial Evaluation of MIS-C.
Figure 3.
Figure 3.
Inpatient Initial Evaluation of MIS-C.
Figure 4.
Figure 4.
Inpatient Management of MIS-C.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Dufort EM, Koumans EH, Chow EJ, et al. New York State and Centers for Disease Control and Prevention Multi-system Inflammatory Syndrome in Children Investigation Team Multisystem inflammatory syndrome in children in New York State. N Engl J Med. 2020;383(4):347–358. - PMC - PubMed
    1. Jones VG, Mills M, Suarez D et al. COVID-19 and Kawasaki disease: novel virus and novel case. Hosp Pediatr. 2020;10(6):537–540. - PubMed
    1. Verdoni L, Mazza A, Gervasoni A et al. An outbreak of severe Kawasaki-like disease at the Italian epicenter of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395(10239):1771–1778. - PMC - PubMed
    1. Riphagen S, Gomez X, Gonzalez-Martinez C et al. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395(10237):1607–1608. - PMC - PubMed
    1. CDC COVID data tracker: United States COVID-19 cases and deaths by state. Centers for Disease Control and Prevention. Updated March 29, 2021. Accessed April 5, 2021. https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days.

LinkOut - more resources