Riphagen et al. United Kingdom3535 Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395:1607-8.
|
8 |
4-14 years |
Unrelenting fever, rash, conjunctivitis, peripheral edema, extremity pain, gastrointestinal symptoms, refractory shock, pleural and pericardial effusions and ascitic No significant respiratory involvement |
RT-PCR not detected Serology not specified |
↑ CRP ↑ PCT ↑ ferritin ↑ triglycerides ↑ D-dimer Negative blood cultures One positive RT-PCR enterovirus/adenovirus |
X-Ray/CT: Lung consolidations, pleural effusion, ascites, ileitis ECHO and EKG: non-specific EKG, echobright coronary vessels giant coronary aneurysm, arrhythmia, myocardial dysfunction, ventricular dilatation |
Whittaker et al. United Kingdom and USA4141 Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P, et al. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA. 2020;324:259-69.
|
58 |
5-14 years |
Fever, sore throat, headache, vomiting, abdominal pain, and diarrhea Rash, conjunctival injection, lymphadenopathy, mucus membrane alterations and red cracked lips, swollen hands and feet, acute kidney injury and shock |
RT-PCR detected (26%) Serology IgG detected (87%) |
↑ CRP and neutrophil counts ↓ albumin and lymphocyte counts ↑ troponin and BNP concentrations compared with those without shock |
ECHO and EKG: non-specific EKG myocardial dysfunction, arrhythmia, coronary abnormalities such as aneurysms and giant aneurysms |
Toubiana et al. France (Paris)4747 Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F, et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020;369:m2094.
|
21 |
3-16 years |
Recent history of headache, cough, coryza, fever, anosmia. ageusia Polymorphous skin rash, changes to the lips/oral cavity, conjunctival injection, gastrointestinal symptoms (abdominal pain, vomiting, diarrhea), peritoneal effusion, irritability, headaches, confusion/meningeal irritation. Myocarditis, hypotensive shock |
RT-PCR detected (38%) Serology IgG detected (90%) |
↑ CRP, PCT, lipase, D-dimer, troponin, and BNP ↓ albumin ↓ lymphocytes and platelets count; neutrophil count ↑ ↑ alanine transaminases and γ-glutamyltransferase ↑ IL-6 ↓ Na Acute kidney injury Anemia No other pathogen was identified, except one serology suggestive of recent Epstein-Barr virus infection Cerebrospinal fluid pleocytosis |
X Ray/CT: Ground glass opacities, local patchy shadowing, interstitial abnormalities ECHO and EKG: Increased QT interval, arrhythmias, signs of ischemia, pericardial effusions, myocardial dysfunction Coronary artery abnormalities, such as increased visibility and dilations. No coronary aneurysms identified |
Belhadjer et al. France and Switzerland3636 Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, et al. Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic Running. Circulation. 2020;142:429-36.
|
35 |
2-16 years |
Fever, asthenia (100%) Abdominal pain, vomiting, diarrhea (80%), respiratory distress (65%), skin rash, cheilitis, cervical adenopathy, meningism, chest pain, heart failure, cardiogenic shock |
RT-PCR detected (40%) Serology IgG detected (86%) |
↑ CRP, PCT, D-dimer, troponin, and BNP ↑ leukocytes and neutrophils ↑ IL-6 |
ECHO and EKG: Unspecific EKG, signs of ischemia ↓ LV ejection fraction, hypokinesis, pericardial effusion, coronary arteries dilatation No coronary aneurysm |
Verdoni et al. Italy (Bergamo)4040 Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395:1771-8.
|
10 |
2-16 years |
Non-exudative conjunctivitis, alterations of the lips or oral cavity, polymorphic rash, lymphadenopathy, diarrhea, coronary aneurysm, pericardial effusion, meningeal signs, hypotension, and clinical signs of hypoperfusion |
RT-PCR detected (20%) Serology IgG detected (80%) |
↑ CRP, ferritin, triglycerides, transaminases, D-dimer, ESR, and fibrinogen ↓ Na and albumin ↓ lymphocytes and platelets count ↑ leukocytes and neutrophils ↑ IL-6, NK ↑ CK, troponin, and BNP No other pathogen was identified |
ECHO: coronary aneurysm, ↓ ejection fraction, valve regurgitation, pericardial effusion X-ray: pneumonia, minimal mono or bilateral infiltrates CT: bibasilar pulmonary thickening EEG: slow wave pattern |
Feldstein et al. USA3737 Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MB, et al. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med. 2020;383:334-46.
|
186 |
8,3 years (average) 1-14 years |
Fever, rash, conjunctivitis, oral mucosal alterations, peripheral extremity changes, lymphadenopathy, abdominal pain, tachycardia, vomiting, diarrhea, cough, dyspnea, arthralgia, myalgia, myocarditis, pericarditis, arrhythmias |
RT-PCR detected (77%) Serology Ig detected (88%) |
↑ CRP, ferritin, D-dimer, fibrinogen, troponin, and BNP, ESR, INR, ALT ↓ hemoglobin and platelets ↓ albumin Lymphocytopenia Neutrophilia |
ECHO: Coronary-artery aneurysms, pericarditis, pericardial effusion, arrhythmia, ↓ ejection fraction |
Dufort et al. USA3838 Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med. 2020;383:347-58.
|
99 |
0-20 years |
Fever, chills, tachycardia, abdominal pain, vomiting, diarrhea, inflammation or enlargement of the appendix/gallbladder, hepatomegaly and/or splenomegaly, conjunctivitis, oral mucosal alterations, rash, headache, lymphadenopathy, cough, sore throat, wheezing, myocarditis |
RT-PCR detected (51%) Serology IgG detected (99%) |
↑ CPR, PCT, ferritin, D-dimer, fibrinogen, troponin, and BNP ↑ IL-6 ↓ albumin |
ECHO: ventricular dysfunction, pericardial effusion, and coronary-artery aneurysm X Ray/CT: opacity |
Capone et al. USA (New York)6060 Capone CA, Subramony A, Sweberg T, Schneider J, Shah S, Rubin L, et al. Characteristics, cardiac involvement, and outcomes of multisystem inflammatory disease of childhood (MIS-C) associated with SARS-CoV-2 infection. J Pediatr. 2020;224:141-5.
|
33 |
8,6 years (average) 5.5-12.6 years |
Fever, clinical signs of complete or incomplete Kawasaki disease, abdominal pain, vomiting, diarrhea, headache, irritability, lethargy, cough, congestion, dyspnea, sore throat, shock with cardiac dysfunction |
RT-PCR detected (9%) Serology IgG detected (91%) |
↑ CPR, PCT, ferritin, transaminases, D-dimer, and fibrinogen ↓ albumin ↓ lymphocytes and platelets count; normal neutrophil count or ↑ ↓ Na ↑ LDH, INR, troponin, and BNP Acute kidney injury Anemia No other pathogen was identified One positive RT-PCR influenza |
ECHO: coronary abnormality, dysfunction |