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ISSN: 0031-3939
Pediatria Polska - Polish Journal of Paediatrics
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2/2021
vol. 96
 
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abstract:
Review paper

Approach to a child with Multisystem Inflammatory Syndrome associated with COVID19. Recommendations by the Polish Paediatric Society Expert Group. Update – February 2021

Magdalena Okarska-Napierała
1
,
Kamila Ludwikowska
2
,
Teresa Jackowska
3
,
Janusz Książyk
4
,
Piotr Buda
4
,
Artur Mazur
5
,
Leszek Szenborn
2
,
Bożena Werner
6
,
Jacek Wysocki
7
,
Ernest Kuchar
1

  1. Department of Pediatrics with Clinical Decisions Unit, Medical University of Warsaw, Warsaw, Poland
  2. Department of Pediatric Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
  3. Department of Pediatrics, The Medical Centre of Postgraduate Education, Warsaw, Poland
  4. Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Warsaw, Poland
  5. Department of Pediatrics, Pediatric Endocrinology and Diabetes, University of Rzeszow, Rzeszow, Poland
  6. Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, Warsaw, Poland
  7. Department of Preventive Health, Poznan University of Medical Science, Poznan, Poland
Pediatr Pol 2021; 96 (2): 121–128
DOI: https://doi.org/10.5114/polp.2021.107395
Online publish date: 2021/07/01
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Multisystem Inflammatory Syndrome in Children (MIS-C) is a new clinical entity occurring in children and young adults, which is associated with the SARS-CoV-2 infection. The first cases of MIS-C were diagnosed in Poland in May 2020. Since October 2020, a significant increase in the incidence of this new disease has been observed in Poland, reflecting the increased incidence of COVID-19 in the paediatric population. MIS-C develops as a result of dysregulation of the immune system occurring 4 weeks after the SARS-CoV-2 infection. Diagnosis is based on the following criteria: a set of clinical features (including fever and signs of multiple organ damage) and elevated inflammatory markers, with exclusion of other causes. The most common complications involve the cardiovascular system: acute myocardial damage with reduced left ventricular ejection fraction, shock, and coronary artery abnormalities and arrhythmias. Mortality in Western Europe and the United States is around 1-2%. Appropriate management, including vital function support and immunomodulatory treatment, allows for a quick recovery in the vast majority of patients. This document is an updated guideline for the diagnostic and therapeutic management of children with suspected MIS-C in Poland. The most important changes concern treatment, steroid therapy, and antiplatelet therapy in particular.
keywords:

Kawasaki disease, MIS-C, PIMS-TS, hyperinflammation