Identifying Multisystem Inflammatory Syndrome in Children After COVID-19 Infection

Abstract

Since its discovery, the novel coronavirus disease 2019 (COVID-19) has evolved into a global pandemic that has affected millions. The pediatric population was once thought to be mostly spared from the SARS-CoV-2 virus. However, a severe hyperinflammatory sequela of the virus known as multisystem inflammatory syndrome in children (MIS-C) has since been identified and poses a great risk to pediatric morbidity and mortality. The goal of this manuscript is to clarify and characterize MIS-C as a diagnosis, including current management and future considerations. Methods: A thorough literature search was performed using Google Scholar and PubMed databases for articles published January 2020 through August 2021. Results: A two-tiered diagnostic approach was created for any pediatric patient presenting with fever and an epidemiologic link to SARS-CoV-2. The mean age at time of diagnosis was 9.3 years old, with 56.8% of patients identifying as male and the majority identifying as either Hispanic (36.5%) or Black (35.1%). Common signs and symptoms included fever, cough, tachycardia and tachypnea. Current treatment recommendations included IVIG, glucocorticoids, and aspirin, with the more severe cases needing hospitalization and immune modulator therapy. Discussion: MIS-C is a serious and potentially fatal sequelae after COVID-19 infection in the pediatric population. Much is still unknown regarding the long-term effects of MIS-C. Further emphasis should be placed on identifying definitive treatment and preventative strategies. Osteopathic family physicians are the primary providers for many of the patients who may present with signs and symptoms of MIS-C, and familiarity with the workup and treatment can help improve care.