Understanding Multisystem Inflammatory Syndrome in Children with COVID-19
April 16, 2021
Multisystem inflammatory syndrome in children (MIS-C) is a rare but is severe hyperinflammatory condition in children and adolescents. It is also known as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. This typically occurs 2–6 weeks after acute SARS-CoV-2 infection. Symptoms include persistent fever, gastrointestinal issues, multiorgan inflammation, low blood pressure, high inflammatory markers, and a variety of other symptoms, including respiratory. Hospital admission has been explicitly included as a requirement in MIS-C case definition. Most patients are discharged after hospital admission for MIS-C, but approximately 60% of patients are admitted to intensive care unit (ICU) and approximately 2% die. The pathogenic mechanisms are not well understood but the delay between infection/exposure and onset suggests inappropriate innate immune responses elicited by infection, sometimes leading to a “cytokine storm”(1). A condition resembling MIS-C, called MIS-A, has been reported, but more rarely, in adults(2). It is not clear, however, that this condition is identical in its pathogenesis to MIS-C.