Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh.
Department of Telemedicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh.
Indian Pediatr. 2022 Jul 15;59(7):563-569. doi: 10.1007/s13312-022-2559-5.
With wide clinical spectrum, multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) in children (MIS-C) is a relatively novel condition occurring weeks to months' post SARS-CoV-2 infection. The aim was to systematically review data on clinical features, laboratory parameters and therapeutics of MIS-C from India.
This systematic review was done as per the PRISMA guidelines, and quality assessment was done using NIH tool for case-series. A systematic search through databases yielded studies whose data was pooled to calculate the mean frequencies with standard deviation using GraphPad software.
Screening of 2548 articles published till December, 2021, yielded 11 case-series. World Health Organization case definition was used widely. There was a slight preponderance of males (57%), median (IQR) age was 7 (6,7) years, 63% (n=305) required intensive care unit admissions, and mortality rate was 10% (n=261). Clinical features included fever, mucocutaneous features (72%), and gastrointestinal problems (62%) in majority. Widely used treatment was corticosteroids (76%) and intravenous immunoglobulin (62%) with other options depending on patient's state. An increased level of inflammatory markers and derangement in other parameters corroborated with disease status. Kawasaki disease like features, not reported in many studies, ranged from 4-76% of patients.
MIS-C presents with a wide spectrum clinical features, increased inflammatory markers and managed as per the disease course and presentation. Future studies monitoring the long-term effects of MIS-C are recommended.
与 2019 年冠状病毒病（COVID-19）相关的儿童多系统炎症综合征（MIS-C）具有广泛的临床谱，是一种在 SARS-CoV-2 感染后数周到数月发生的相对新型疾病。本研究旨在系统地回顾印度关于 MIS-C 的临床特征、实验室参数和治疗的数据。
本系统评价按照 PRISMA 指南进行，使用 NIH 病例系列工具进行质量评估。通过数据库进行系统搜索，对符合条件的研究进行数据汇总，使用 GraphPad 软件计算平均值和标准差。
对截至 2021 年 12 月发表的 2548 篇文章进行筛选，得到 11 项病例系列研究。广泛使用世界卫生组织的病例定义。男性（57%）略占优势，中位数（IQR）年龄为 7（6，7）岁，63%（n=305）需要入住重症监护病房，死亡率为 10%（n=261）。大多数患者有发热、黏膜皮肤特征（72%）和胃肠道问题（62%）等临床表现。广泛使用的治疗方法是皮质类固醇（76%）和静脉注射免疫球蛋白（62%），根据患者的病情还有其他选择。炎症标志物水平升高和其他参数异常与疾病状态相符。许多研究未报告川崎病样特征，其范围为 4-76%的患者。
MIS-C 的临床表现广泛，炎症标志物升高，根据疾病进程和表现进行治疗。建议未来的研究监测 MIS-C 的长期影响。
