A Comprehensive Review of SARS-CoV-2-Associated Multisystem Inflammatory Syndrome in Children

Document Type : Original article

Authors

1 Department of Pediatrics, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.

2 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 MD, Faculty of Medicine, Islamic Azad University – Mashhad Branch, Mashhad, Iran

4 MD, Faculty of Medicine, Islamic Azad University – Mashhad Branch, Mashhad, Iran.

5 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

6 Faculty of Pharmacy, Islamic Azad University – Damghan Branch, Damghan, Iran

7 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

The coronavirus disease 2019 (COVID-19) has affected individuals across all age groups, with a notably high rate of morbidity and mortality. Although most children with COVID-19 exhibit mild symptoms, an increasing proportion are developing a novel multisystem inflammatory syndrome (MIS-C), which shares clinical features with Kawasaki disease. MIS-C is a newly recognized hyperinflammatory condition affecting virtually any organ system. The most common symptoms include fever and gastrointestinal disturbances, although neurologic and dermatologic manifestations are well-documented. The clinical presentation of MIS-C overlaps with that of Kawasaki disease, toxic shock syndrome, and other shock syndromes, making accurate diagnosis challenging. Elevated inflammatory markers are frequently observed in MIS-C patients, and abnormalities on echocardiograms or electrocardiograms may be present. Treatment for MIS-C should consider intravenous immunoglobulin, anticoagulation, and corticosteroids. Despite significant cardiovascular involvement in some cases, most patients recover without complications. However, long-term echocardiographic follow-up is essential, as coronary aneurysms have been documented. This narrative review examines the epidemiology, pathophysiology, clinical manifestations, laboratory findings, diagnostic criteria, and treatment strategies for MIS-C to enhance pediatricians' understanding of this emerging syndrome.

Keywords

References

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Reviews in Clinical Medicine
Volume 12, Issue 2
April 2025
Pages 59-66

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