COVID-19: meta-analysis highlights clinical features of MIS-C

  • Yasuhara J & al.
  • Pediatr Pulmonol
  • 11 Jan 2021

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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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.