Systemic inflammatory syndrome in COVID-19�SISCoV study: systematic review and meta-analysis

Dhar, D and Dey, T and Samim, MM and Padmanabha, H and Chatterjee, A and Naznin, P and Chandra, SR and Mallesh, K and Shah, R and Siddiqui, S and Pratik, K and Ameya, P and Abhishek, G (2021) Systemic inflammatory syndrome in COVID-19�SISCoV study: systematic review and meta-analysis. In: Pediatric Research .

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Abstract

Background: There has been a recent upsurge in the cases of Multisystem inflammatory syndrome in children (MIS-C) associated with Coronavirus disease (COVID-19). We performed a systematic review and meta-analysis on the demographic profile, clinical characteristics, complications, management, and prognosis of this emerging novel entity. Methods: Using a predefined search strategy incorporating MeSH terms and keywords, all known literature databases were searched up till 10th July 2020. The review was done in accordance with PRISMA guidelines and registered in PROSPERO (CRD4202019757). Results: Of the 862 identified publications, 18 studies comprising 833 patients were included for meta-analysis. The socio-demographic profile showed male predilection (p = 0.0085) with no significant racial predisposition. A higher incidence of gastrointestinal symptoms (603/715, 84.3), myocarditis (191/309, 61.8), left ventricular dysfunction (190/422, 45.0), pericardial (135/436, 31.0) and neurological symptoms (138/602, 22.9) was reported. Serological evidence of SARS-CoV-2 had higher sensitivity compared to rtPCR (291/800, 36.4 vs 495/752, 65.8; p < 0.001). Coronary artery anomaly (CAA) was reported in 117/681 in 9 publications (17.2). A total of 13 (1.6) fatalities were reported. Conclusion: Clinicians need to be vigilant in identifying the constellation of these symptoms in children with clinical or epidemiologic SARS-CoV-2 infection. Early diagnosis and treatment lead to a favorable outcome. Impact: Key messageThis review analyses the demographic profile, clinical spectrum, management strategies, prognosis, and pathophysiology of MIS-C among children with SARS-CoV-2 infection.The stark differences of MIS-C from Kawasaki disease with respect to demographics and clinical spectrum is addressed.Over-reliance on rtPCR for diagnosis can miss the diagnosis of MIS-C. New addition to existing literatureThe first systematic review and meta-analysis of published literature on MIS-C associated with COVID-19. Impact: The article will serve to spread awareness among the clinicians regarding this emerging novel entity, so that diagnosis can be made early and management can be initiated promptly. © 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.

Item Type:	Journal Article
Publication:	Pediatric Research
Publisher:	Springer Nature
Additional Information:	The copyright for this article belongs to Authors
Department/Centre:	Division of Interdisciplinary Sciences > Centre for Biosystems Science and Engineering
Date Deposited:	16 Aug 2021 09:49
Last Modified:	16 Aug 2021 09:49
URI:	http://eprints.iisc.ac.in/id/eprint/69204

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