Multisystem Inflammatory Syndrome in Children (MIS-C) of Asian Countries: A Mini-Literature Review on its Clinical Characteristics and Outcomes

Main Article Content

Mehnaaz Sameera Arifuddin http://orcid.org/0000-0002-9037-8108 Mohammed Abdul Hannan Hazari http://orcid.org/0000-0003-4097-7564

Abstract

COVID-19 pandemic though has reached endemic levels in most of the countries, it has left an indelible mark on the healthcare systems across the world. One of the emerging challenges faced by physicians and researchers all around the world is the increased incidence of Multisystem inflammatory syndrome in children (MIS-C). Most of the research work conducted till date focusses on the pathophysiology, management and treatment of this syndrome. Multisystem inflammatory syndrome in children has been found to be a consequence of hyperactive immune system resulting from cytokine activation and release of immune complexes subsequent to COVID-19 infection. This condition is also associated with multisystem dysfunction which if not diagnosed early and not treated promptly, could result in an increased mortality among children. Most of the cases have been reported from European and American countries, but not many from Asia.


This literature review provides for plausible reasons as to why the incidence of multisystem inflammatory syndrome in children has been less in Asian countries compared to the rest of the world. It also gives insights into the treatment protocols for multisystem inflammatory syndrome in children followed by hospitals in these countries and also highlights how different MIS-C is from Kawasaki disease in terms of clinical presentation since both these conditions share a common disease spectrum. This review also lists out the clinical features and treatment followed in such patients belonging to Asian countries.

Keywords: Multisystem inflammatory syndrome, children, COVID-19, Kawasaki disease, Asian countries

Article Details

How to Cite
ARIFUDDIN, Mehnaaz Sameera; HAZARI, Mohammed Abdul Hannan. Multisystem Inflammatory Syndrome in Children (MIS-C) of Asian Countries: A Mini-Literature Review on its Clinical Characteristics and Outcomes. Medical Research Archives, [S.l.], v. 11, n. 7.2, july 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4070>. Date accessed: 19 june 2024. doi: https://doi.org/10.18103/mra.v11i7.2.4070.
Section
Review Articles

References

1. WHO Coronavirus (COVID-19) dashboard. https://covid19.who.int/. Accessed March 28, 2023.
2. India: WHO Coronavirus disease (COVID-19) dashboard with vaccination data. https://covid19.who.int/region/searo/country/in. Accessed March 28, 2023.
3. Shah SK and Munoz AC. Multisystem inflammatory syndrome in children in COVID-19 pandemic. The Indian Journal of Pediatrics. 2020;87(9):671-3. https://doi.org/10.1007/s12098-020-03440-7.
4. Arifuddin MS. Emergence of MIS-C in COVID-19 pandemic. Annals of Medical Physiology. 2020;4(3):22-3.
5. Son MBF, Friedman K, Fulton DR, Kaplan SL, Sundel R, Randolph AG, TePas E. COVID-19: Multisystem inflammatory syndrome in children (MIS-C) clinical features, evaluation and diagnosis. UpToDate. 2023; https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-clinical-features-evaluation-and-diagnosis. Accessed March 28, 2023.
6. Multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection case report form. https://ndc.services.cdc.gov/case-definitions/multisystem-inflammatory-syndrome-in-children-mis-c/. Accessed March 28, 2023.
7. Al Maskari N, Al Mukhaini K, Al Abrawi S, Al Reesi M, Al Abulsalam J, Elsidig N. SARS-CoV-2-related multisystem inflammatory syndrome in children: a case series. Sultan Qaboos Univ Med J. 2021;21(2):e302-e307. doi: 10.18295/squmj.2021.21.02.021.
8. Patnaik S, Jain MK, Ahmed S, Dash AK, Kumar RP, Sahoo B, Mishra R, Behera MR. Short-term outcomes in children recovered from multisystem inflammatory syndrome associated with SARS-CoV-2 infection. Rheumatol Int. 2021;41(11):1957-62. doi: 10.1007/s00296-021-04932-1.
9. Rostami-Maskopaee F, Ladomenou F, Razavi-Amoli SK, Navaeifar MR, Hajialibeig A, Shahbaznejad L, et al. Clinical characteristics and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in Iran: a multicentric study. PLoS One. 2022;17(9):e0274104. doi: 10.1371/journal.pone.0274104.
10. Fukuzawa S, Kubota J, Murasaki W, Saito R, Takahata N. First case of COVID-19 L452R-induced multisystem inflammatory syndrome in a child in Japan. Pediatr Int. 2022;64(1):e15242. doi: 10.1111/ped.15242.
11. Fukuda S, Kaneta M, Miyake M, Ohya T, Miyakawa K, Iwamoto M, Ito S. A case of multisystem inflammatory syndrome in children in a Japanese boy: with discussion of cytokine profile. Mod Rheumatol Case Rep. 2021;5(2):442-7. doi: 10.1080/24725625.2021.1920140.
12. Asseri AA, AlHelali I, Elbastawisi E, Ali AS, Al-Qahtani SM, Shati AA, Awadalla NJ. Multi-system inflammatory syndrome in children during the coronavirus disease 2019 in Saudi Arabia: clinical perspective from a case series. Medicine (Baltimore). 2021;100(22):e25919. doi: 10.1097/MD.0000000000025919.
13. Bahrami A, Vafapour M, Moazzami B, Rezaei N. Hyperinflammatory shock related to COVID-19 in a patient presenting with multisystem inflammatory syndrome in children: first case from Iran. J Paeditr Child Health. 2021;57(6):922-5. doi: 10.1111/jpc.15048.
14. Rayamajhi A, Sharma M, Deo MK, Shreshta S, Bista KP, Paudel KP. Kawasaki disease like multisystem inflammatory syndrome in a toddler during SARS-CoV-2 pandemic in Nepal. J Nepal Health Res Counc. 2021;18(4):789-91. doi: 10.33314/jnhrc.v18i4.3281.
15. Lee JH, Han HS, Lee JK. The importance of early recognition, timely management and the role of healthcare providers in multisystem inflammatory syndrome in children. J Korean Med Sci. 2021;36(2):e17. doi: 10.3346/jkms.2021.36.e17.
16. Jain S, Sen S, Lakshmivenkateshiah S, Bobhate P, Venkatesh S, Udani S, et al. Multisystem inflammatory syndrome in children with COVID-19 in Mumbai, India. Indian Pediatr. 2020;57(11):1015-9. doi: 10.1007/s13312-020-2026-0.
17. Rauf A, Vijayan A, John ST, Krishnan R, Latheef A. Multisystem inflammatory syndrome with features of atypical Kawasaki disease during COVID-19 pandemic. Indian J Pediatr. 2020;87(9):745-7. doi: 10.1007/s12098-020-03357-1.
18. Wang WY, Wang YJ, An CX, Zhao QJ, Wang SY, Li WY, Yi B, Li H. Multisystem inflammatory syndrome (MIS-C) with SARS-CoV-2 omicron variant BA.2.38 in a four-year-old Chinese girl: a case report. Front Public Health. 2022;10:1021200. doi: 10.3389/fpubh.2022.1021200.
19. Mamishi S, Olfat M, Pourakbari B, Eshaghi H, Abdolsalehi MR, Shahbabaie MA, et al. Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in children: update and new insights from the second report of an Iranian referral hospital. Epidemiol Infect. 2022;150:e179.
20. Venkataraman A, Kumar NP, Hanna LE, Putlibai S, Karthick M, Rajamanikam A, et al. Plasma biomarker profiling of PIMS-TS, COVID-19 and SARS-CoV-2 seropositive children-a cross-sectional observational study from Southern India. EBioMedicine. 2021;66:103317. DOI:https://doi.org/10.1016/j.ebiom.2021.103317.
21. Venkatesha GA, Srinivas N, Mohamedali S, Chandrasekar S. Sudden cardiac death in a young boy with multisystemic inflammatory syndrome in children (MISC). BMJ Case Rep. 2021;14(8):e242635. doi: 10.1136/bcr-2021-242635.
22. Abi Nassif TH, Daou KN, Tannoury T, Majdalani M. Cardiac involvement in a child post COVID-19: a case from Lebanon. BMJ Case Rep. 2021;14(6):e242084. doi: 10.1136/bcr-2021-242084.
23. Shahbaznejad L, Navaeifar MR, Abbaskhanian A, Hosseinzadeh F, Rahimzadeh G, Rezai MS. Clinical characteristics of 10 children with a pediatric inflammatory multisystem syndrome associated with COVID-19 in Iran. BMC Pediatr. 2020;20(1):513. doi: 10.1186/s12887-020-02415-z.
24. Nadua KD, Chong CY, Kam KQ, Mok YH, Choo JTL, Lam JCM, Li J, Tan NWH, Yung CF, Chan SWB, The KL, Das L, Arkachaisri T, Thoon KC. Multisystem inflammatory syndrome in children in Singapore. Ann Acad Med Singao. 2022;51(11):669-76. doi: 10.47102/annals-acadmedsg.202283.
25. Al Qahtani M, Uddin MS, Al Fulayyih S, Al Baridi S, Hamid Z. An 11-year-old Saudi Arabian girl who presented with multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection with coronary artery aneurysm and cardiac involvement: a case report. Am J Case Rep. 2021;22:e933053. doi: 10.12659/AJCR.933053.
26. Lio K, Uda K, Hataya H, Yasui F, Hinda T, Sanada T, et al. Kawasaki disease or Kawasaki-like disease: influence on SARS-CoV-2 infections in Japan. Acta Pediatr. 2021;110(2):600-1. doi: 10.1111/apa.15535.
27. Gurlevik LS, Gunbey C, Ozsurekci Y, Oygar PD, Kesici S, Gocmen R, et al. Neurologic manifestations in children with COVID-19 from a tertiary center in Turkey and literature review. Eur J Peadiatr Neurol. 2022;37:139-54. doi: 10.1016/j.ejpn.2022.02.003.
28. Vella LA and Rowley LH. Current insights into the pathophysiology of multisystem inflammatory syndrome in children. Current Pediatrics Reports. 2021;9:83-92. doi: 10.1007/s40124-021-00257-6.
29. Jaing L, Tang K, Levin M, Irfan O, Morris SK, Wilson L, Klein JD, Bhutta ZA. COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect Dis. 2020;20(11):e276-e288. doi: 10.1016/S1473-3099(20)30651-4.
30. Shankaralingappa A and Thirunavukkarasu AB. Pathogenesis of COVID-19 and multi-system inflammatory syndrome in children. Int J Contemp Pediatr. 2021;8:777-81. DOI: https://doi.org/10.18203/2349-3291.ijcp20211096.
31. Farooqi KM, Chan A, Weller RJ, Mi J, Jiang P, Abrahams E, et al. Longitudinal outcomes for multisystem inflammatory syndrome in children. Pediatrics. 2021;148(2):e2021051155. doi: 10.1542/peds.2021-051155.
32. Matucci-Cerenic C, Caorsi R, Consolaro A, Rosina S, Civino A, Ravelli A. Multisystem inflammatory syndrome in children: unique disease or part of KD spectrum? Frontiers in Pediatrics Medicine. 2021;9: https://doi.org/10.3389/fped.2021.680813.
33. Li W, Tang Y, Shi Y, Chen Y, Liu E. Why multisystem inflammatory syndrome in children has been less commonly described in Asia? Transl Pediatr. 2020;9(6):873-5. doi: 10.21037/tp-20-151.
34. Aizawa Y, Takanashi S, Ogimi C. Updates on coronavirus disease 2019 in children in Japan. Pediatr Infect Dis J. 2022;41(11):e461-e467. doi: 10.1097/INF.0000000000003641.
35. Therapeutic Management of Hospitalized Pediatric Patients With Multisystem Inflammatory Syndrome in Children (MIS-C). https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-children/hospitalized-pediatric-patients--therapeutic-management-of-mis-c/. Accessed May 16, 2023.
36. Amor O, Goldberg Y, Mandel M, Bar-On YM, Bodenheimer O, Freedman L, et al. Initial protection against SARS-CoV-2 omicron lineage infection in children and adolescents by BNT162b2 in Israel: an observational study. Lancet Infect Dis. 2023;23(1):67-73. doi:https://doi.org/10.1016/S1473-3099(22)00527-8.