Sandbox:Javaria
COVID-19 associated multi-system inflammatory syndrome in children
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: [..]
Synonyms and keywords: ; (MIS-C); (MIS-C) associated with COVID-19; (MIS-C) associated with SARS-CoV-2; Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19); Multisystem Inflammatory Syndrome in Children associated with COVID-19
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating COVID-19 associated multi-system inflammatory syndrome in children from other diseases
- COVID-19 associated multi-system inflammatory syndrome in children must be differentiated from other diseases that cause rash such as Kawasaki disease and toxic shock syndrome.
- Kawasaki disease A patient with fever for 5 or more days and at least 4 clinical signs (rash, bilateral conjunctival injection, more than 1.5 cm of cervical lymphadenopathy, oral mucosal changes and extremity changes) is known to have Kawasaki disease. Typically a patient is less than 5 years of age. [1]
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
WHO preliminary case definition
A preliminary case is a patient 0-19 years of age having a fever for more than three days and at least two of the following findings[2]:
- Rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs (oral, hands or feet).
- Hypotension or shock.
- Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated Troponin/NT-proBNP),
- Evidence of coagulopathy (by PT, PTT, elevated d-Dimers).
- Acute gastrointestinal problems (diarrhea, vomiting, or abdominal pain).
AND
- Elevated markers of inflammation such as ESR, C-reactive protein, or procalcitonin.
AND
- No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes.
AND
- Evidence of COVID-19 (RT-PCR, antigen test or serology positive), or likely contact with patients with COVID-19.
History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram |Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies