Multi-System Inflammatory Syndrome in Children in Association with COVID-19


Multi-System Inflammatory Syndrome in Children in Association with COVID-19.

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Simpson JM, Newburger JW.
Circulation. 2020 Jun 11. doi: 10.1161/CIRCULATIONAHA.120.048726. Online ahead of print.
PMID: 32525700

Take Home Points:

  • Multisystem inflammation in children (MIS-C) is a newly recognized syndrome mimicking Kawasaki disease in some aspects of clinical presentation and clinical course temporally associated with COVID-19 infection.
  • Multisystem inflammatory syndrome in children shares similarities with atypical Kawasaki disease, however, clinical criteria of diagnosis of Kawasaki disease was not fulfilled.
  • Coronary dilation including giant aneurysm can happen.
  • Markers of inflammation and cardiac involvement—including troponin I, brain natriuretic peptide, D-dimer, C-reactive protein, and interleukin 6—were all elevated.
  • Left ventricular systolic dysfunction requiring ionotropic support is common.
  • Additional studies are needed to determine the longer-term impact of MIS-C on myocardial function and coronary arteries.
  • The optimal treatment for MIS-C is uncertain. Patients are often treated with immunomodulatory therapy including intravenous immunoglobulin and steroids. In more severe cases e anakinra, infliximab, or tocilizumab has been used.

Dr Shaji Menon

Comment from Dr. Shaji Menon (Salt Lake City, Utah), section editor of Pediatric Cardiology Journal Watch:  This article is an excellent commentary on the above discussed original article by Simpson and Newburger.

case definitions for multisystem inflammatory syndrome in children