Takeaway
- COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) is marked by myocardial and gastrointestinal (GI) symptoms in mostly older children (mean age, 9.3 years).
Why this matters
- The clinical features of MIS-C differ from those of Kawasaki disease, which affects younger children and has fewer myocardial and GI symptoms.
Study design
- Meta-analysis of 27 observational studies (N=917).
- Funding: None disclosed.
Key results
- The mean age was 9.3 (95% CI, 8.4-10.1) years.
- The pooled prevalence was 34.6% in Hispanic children and 31.5% in Black children.
- The most common symptoms (95% CIs) included:
- GI: 87.3% (82.9%-91.6%).
- Cardiovascular:
- Myocardial dysfunction: 55.3% (42.4%-68.2%).
- Coronary artery aneurysms: 21.7% (12.8%-30.1%).
- Shock: 65.8% (51.1%-80.4%).
- Most children were treated with:
- Intravenous immunoglobulin: 81.0% (75.0%-86.9%).
- Aspirin: 67.3% (48.8%-85.7%).
- Corticosteroids: 63.6% (53.4%-73.8%).
- Extracorporeal membrane oxygenation: 6.3% (2.8%-9.8%).
- Myocardial dysfunction improved in 55.1% (33.4%-76.8%) by discharge.
- Mortality was 1.9% (1.0%-2.8%).
Limitations
- Small number of patients.
- All observational designs.
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