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Special Issue "Advances in Pediatric Multisystem Inflammatory Syndrome (MIS-C)"

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global and Public Health".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 3886

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Special Issue Editors

Dr. Francesco La Torre

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Guest Editor

Department of Pediatrics, Pediatric Rheumatology Center, Ospedale Pediatrico "Giovanni XXIII", AOU Consorziale Policlinico, Bari, Italy
Interests: pediatrics; rheumatology; autoinflammatory diseases; vasculitis

Prof. Dr. Marco Cattalini

E-Mail Website
Guest Editor

Pediatric Clinic, University of Brescia and Spedali Civili di Brescia, 25123 Brescia, Italy
Interests: pediatrics; rheumatology; autoinflammatory diseases; synovial fluid; systemic lupus erythematosus; autoimmune disease; cytokines; TNF; autoimmune disorders; arthritis

Prof. Dr. Andrea Taddio

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Guest Editor

1. Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
2. Institute of Maternal and Child Health, IRCCS Burlo Garofolo, 34137 Trieste, Italy
Interests: pediatrics; rheumatology; clinical immunology

Special Issue Information

Dear Colleagues,

Multisystem inflammatory syndrome in children (MIS-C) is a newly identified clinical entity that has been linked to SARS-CoV-2 infection in children, adolescents and young adults.

MIS-C represents a “hot topic” at present, given the direct correlation with SARS-CoV-2 infection and the high percentage of patients requiring intensive care unit (ICU) admission and aggressive therapy. Indeed, data regarding disease epidemiology and pathogenesis, but also the best treatment strategy and outcome, are very heterogeneous. Recently, a more aggressive therapeutic approach in the early phases of the disease showed greater efficacy in terms of reducing ICU access and allowing better long-term outcomes.

The purpose of this Special issue is to provide cutting-edge data on MIS-C, for a better understanding of all aspects of the disease. Original data from observational and registry studies will be kept in the utmost consideration, but we will also consider reviews and case reports if they present advances in our understanding of the disease.

Dr. Francesco La Torre
Prof. Dr. Marco Cattalini
Prof. Dr. Andrea Taddio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

multisystem inflammatory syndrome in children (MIS-C)
Kawasaki disease (KD)
Anti IL-1
COVID-19
hyperinflammation
treatment
outcome

Published Papers (4 papers)

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Open AccessArticle

Incidence and Prevalence of Multisystem Inflammatory Syndrome in Children (MIS-C) in Southern Italy

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Children 2023, 10(5), 766; https://doi.org/10.3390/children10050766 - 23 Apr 2023

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Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a pediatric hyperinflammatory syndrome related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection whose epidemiology is not very well known at present. The objective of the study was to better understand the incidence of MIS-C in the Apulia region in southern Italy. Our primary goal was to estimate the incidence of newly identified cases of MIS-C in children aged 0–18 years, during a period of six months, encompassing the second pandemic wave. We also analyzed the characteristics of our cohort in terms of clinical features, treatment, and outcomes. The cumulative incidence of MIS-C was 3.27 per 100,000 residents between 0 and 18 years of age. In our cohort, gastrointestinal, mucocutaneous, and cardiac involvement were the most common clinical features. With our step-up approach to therapy, no patients required intensive care unit (ICU) admission and no cardiac sequelae after 6 months of onset were found in echocardiograms. Conclusion: Our epidemiological study of MIS-C in southern Italy showed unexpectedly overlapping figures with other US studies. Full article

(This article belongs to the Special Issue Advances in Pediatric Multisystem Inflammatory Syndrome (MIS-C))

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Open AccessBrief Report

Determination of Risk Factors for Severe Life-Threatening Course of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children

Ilia S. Avrusin

Natalia N. Abramova

Konstantin E. Belozerov

Julia E. Konstantinova

Eugenia A. Isupova

Tatiana L. Kornishina

Vera V. Masalova

Eugeniy Yu. Felker

Olga V. Kalashnikova

Vyacheslav G. Chasnyk

Yuriy S. Aleksandrovich

and

Mikhail M. Kostik

Children 2023, 10(8), 1366; https://doi.org/10.3390/children10081366 - 09 Aug 2023

Viewed by 548

Abstract

Multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a life-threatening condition that often requires intensive care unit (ICU) admission. The aim of this study was to determine risk factors for severe/life-threatening course of MIS-C. The study included 166 patients (99 boys, 67 girls) aged 4 months–17 years (median 8.2 years). The criterion of severity was the fact of ICU admission. To conduct a comparative analysis, MIS-C patients were divided into two groups: patients hospitalized in the ICU (n = 84, 50.6%) and those who did not need ICU admission (n = 82, 49.4%). Patients with a more severe course of MIS-C were significantly older. They had a higher frequency of signs such as rash, swelling, hepatomegaly, splenomegaly, and neurological and respiratory symptoms. Hypotension/shock and myocardial involvement were much more common in patients with severe MIS-C. These patients had a more significant increase in CRP, creatinine, troponin, and D-dimer levels. Additionally, the presence of macrophage activation syndrome was higher in patients admitted to the ICU. Conclusion: Nineteen predictors of severe course of MIS-C were found, out of which hepatomegaly, splenomegaly, D-dimer > 2568 ng/mL, troponin > 10 pg/mL were mainly associated with the probability of being classified as early predictors of severe MIS-C requiring ICU admission. Full article

(This article belongs to the Special Issue Advances in Pediatric Multisystem Inflammatory Syndrome (MIS-C))

Open AccessOpinion

Multi-Inflammatory Syndrome in Children (MIS-C) in 2023: Is It Time to Forget about It?

and

Children 2023, 10(6), 980; https://doi.org/10.3390/children10060980 - 31 May 2023

Cited by 1 | Viewed by 746

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is defined as a clinically serious condition requiring hospitalization involving fever, multi-system organ dysfunction, and an increase in inflammatory biomarkers. The syndrome was originally described as a post-infectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which usually causes COVID-19. During the COVID-19 pandemic, not only did the virus undergo mutations but vaccines against SARS-CoV-2 were also developed. Both these conditions led to a decrease in the incidence of MIS-C. This narrative review summarizes the recent updates for MIS-C, particularly regarding the change in incidence, the link between the SARS-CoV-2 vaccine and MIS-C, and new updates of MIS-C treatments. Full article

(This article belongs to the Special Issue Advances in Pediatric Multisystem Inflammatory Syndrome (MIS-C))

Open AccessCase Report

Thrombotic Events in MIS-C Patients: A Single Case Report and Literature Review

and

Maria Vincenza Mastrolia

Children 2023, 10(4), 618; https://doi.org/10.3390/children10040618 - 25 Mar 2023

Viewed by 792

Abstract

Multisystem Inflammatory Syndrome in Children (MIS-C) is a systemic hyperinflammatory disorder that is associated with a hypercoagulable state and a higher risk of thrombotic events (TEs). We report the case of a 9-year-old MIS-C patient with a severe course who developed a massive pulmonary embolism that was successfully treated with heparin. A literature review of previous TEs in MIS-C patients was conducted (60 MIS-C cases from 37 studies). At least one risk factor for thrombosis was observed in 91.7% of patients. The most frequently observed risk factors were pediatric intensive care unit hospitalization (61.7%), central venous catheter (36.7%), age >12 years (36.7%), left ventricular ejection fraction <35% (28.3%), D-dimer >5 times the upper limit of normal values (71.9%), mechanical ventilation (23.3%), obesity (23.3%), and extracorporeal membrane oxygenation (15%). TEs may concurrently affect multiple vessels, including both arterial and venous. Arterial thrombosis was more frequent, mainly affecting the cerebral and pulmonary vascular systems. Despite antithrombotic prophylaxis, 40% of MIS-C patients developed TEs. Over one-third of patients presented persistent focal neurological signs, and ten patients died, half of whom died because of TEs. TEs are severe and life-threatening complications of MIS-C. In case with thrombosis risk factors, appropriate thromboprophylaxis should be promptly administered. Despite proper prophylactic therapy, TEs may occur, leading in some cases to permanent disability or death. Full article

(This article belongs to the Special Issue Advances in Pediatric Multisystem Inflammatory Syndrome (MIS-C))

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Special Issue "Advances in Pediatric Multisystem Inflammatory Syndrome (MIS-C)"

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