Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes.
Level 4 - case-series / case-control
Systematic review and meta-analysis of observational studies and case series
PubMed 34863701 · doi:10.1016/j.jped.2021.08.006
What was done
The authors conducted a systematic review and meta-analysis across seven databases (PubMed, Scielo, Web of Science, Science Direct, EMBASA, EBSCO, and Scopus) searching for articles on pediatric multisystem inflammatory syndrome (MIS-C/PIMS-TS) associated with COVID-19 published between December 1, 2019, and July 10, 2021. Studies were evaluated using PRISMA guidelines and the Newcastle-Ottawa Scale to assess clinical characteristics, comorbidities, symptoms, treatments, and patient outcomes.
What was found
The meta-analysis included 98 studies representing 2,275 patients with MIS-C. The average age was 9 years, and 56.8% were male. Fever was present in 100% of cases, gastrointestinal symptoms in 82%, and abdominal pain in 68%. Shock or hypotension was common. Cardiac symptoms (66%) were more frequent than respiratory (39%) or neurological (28%) symptoms. Treatments aligning with septic shock and Kawasaki disease protocols were noted to be effective.
Why it matters
This review synthesizes early pandemic data on MIS-C, delineating its predominant presentation as a combination of fever, gastrointestinal distress, and cardiac involvement to aid in early hospital identification and treatment.
Limits
The review relies on observational studies and case series published during the initial phases of the pandemic, which carry risk of publication and reporting bias. Specific treatment regimens, comparative efficacy estimates, and detailed confidence intervals are not reported in the abstract.
Cited by
- supports A Kawasaki disease-like inflammatory illness occurs in children following COVID-19 infection.