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| __NOTOC__
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| ==COVID-19 associated multi-system inflammatory syndrome in children==
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| {{CMG}}; {{AE}} [..]<br>
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| {{SK}} ; (MIS-C); (MIS-C) associated with COVID-19; (MIS-C) associated with SARS-CoV-2; Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19); Multisystem Inflammatory Syndrome in Children associated with COVID-19; Hyperinflammatory shock in children during COVID-19 pandemic. <br>
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children|Overview]]==
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| COVID-19 associated Multi-system Inflammatory Syndrome in Children is a new disease entity affecting children less than 21 years of age. The diagnostic criteria include fever and inflammation with multiorgan involvement AND no alternative diagnoses AND COVID-19 positive or history of exposure.
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children|Historical Perspective]]==
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| It was not long after the elderly and immunocompromised were considered high-risk for COVID-19, that Multi-system Inflammatory Syndrome in Children drew the clinicians' attention. An increasing number of severe inflammatory syndrome cases in the pediatric population was highlighted by the physicians in the United Kingdom on April 26th, 2020. The children although previously healthy were COVID-19 positive or had a history of close contact with COVID-19 patients.<ref name="urlHAN Archive - 00432 | Health Alert Network (HAN)">{{cite web |url=https://emergency.cdc.gov/han/2020/han00432.asp |title=HAN Archive - 00432 | Health Alert Network (HAN) |format= |work= |accessdate=}}</ref> Since then the cases of COVID-19 associated Multi-system Inflammatory Syndrome in Children are on the rise, as are COVID-19 cases in adolescents.
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children|Pathophysiology]]==
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children|Causes]]==
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children|Differentiating COVID-19 associated multi-system inflammatory syndrome in children from other diseases]]==
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| :COVID-19 associated multi-system inflammatory syndrome in children must be differentiated from other diseases that cause [[rash]] such as [[Kawasaki disease]] and [[toxic shock syndrome]].
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| *[[Kawasaki disease]] A patient with fever for 5 or more days and at least 4 clinical signs ([[rash]], bilateral conjunctival injection, more than 1.5 cm of cervical [[lymphadenopathy]], oral mucosal changes and extremity changes) is known to have Kawasaki disease. Typically a patient is less than 5 years of age. <ref name="urlCase Definition | Kawasaki Disease | CDC">{{cite web |url=https://www.cdc.gov/kawasaki/case-definition.html |title=Case Definition | Kawasaki Disease | CDC |format= |work= |accessdate=}}</ref>
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| *[[Toxic Shock Syndrome]]
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| __NOTOC__
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children epidemiology and demographics|Epidemiology and Demographics]]==
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| The nature of COVID-19 associated multi-system inflammatory syndrome in children makes the data requiring an update all the time. No causal relationship to any demographic factor has been established.
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| ===Age===
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| The diagnostic criteria including children age less than 21 years helps highlight the age group that can be affected. The limited data of eight patients showed the affected children's age between 4- 14 years. <ref>{{cite journal|doi=10.1016/ S0140-6736(20)31094-1}}</ref>
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| ===Mortality===
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| *The limited data available shows low mortality due to COVID-19 associated multi-system inflammatory syndrome in children.
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| ===Geographic Distribution===
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| * Most of the cases have been reported in North America and Europe but the evolving nature of itself COVID-19 and COVID-19 associated multi-system inflammatory syndrome in children requires more effort to keep the world updated.
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| ==[[COVID-19 associated multi-system inflammatory syndrome in childrenrisk factors|Risk Factors]]==
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children screening|Screening]]==
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| ==[[COVID-19 associated multi-system inflammatory syndrome in children natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
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| ==Diagnosis==
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| ==WHO preliminary case definition==
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| A preliminary case is a patient 0-19 years of age having a fever for more than three days and at least two of the following findings<ref>[https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19| WHO reports multisystem-inflammatory-syndrome in children with COVID-19]</ref>:
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| *#Rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs (oral, hands or feet).
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| *#Hypotension or shock.
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| *#Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated Troponin/NT-proBNP),
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| *#Evidence of coagulopathy (by PT, PTT, elevated d-Dimers).
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| *#Acute gastrointestinal problems (diarrhea, vomiting, or abdominal pain).
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| AND
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| *Elevated markers of inflammation such as [[ESR]], [[C-reactive protein]], or [[procalcitonin]].
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| AND
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| *No other obvious microbial cause of inflammation, including bacterial [[sepsis]], staphylococcal or streptococcal shock syndromes.
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| AND
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| *Evidence of COVID-19 (RT-PCR, antigen test or [[serology]] positive), or likely contact with patients with COVID-19.
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| [[COVID-19 associated multi-system inflammatory syndrome in children history and symptoms|History and Symptoms]] | [[COVID-19 associated multi-system inflammatory syndrome in children physical examination|Physical Examination]] | [[COVID-19 associated multi-system inflammatory syndrome in children laboratory findings|Laboratory Findings]] | [[COVID-19 associated multi-system inflammatory syndrome in children electrocardiogram|Electrocardiogram]] |[[COVID-19 associated multi-system inflammatory syndrome in children here chest x ray|Chest X Ray]] | [[COVID-19 associated multi-system inflammatory syndrome in children CT|CT]] | [[COVID-19 associated multi-system inflammatory syndrome in children MRI|MRI]] | [[COVID-19 associated multi-system inflammatory syndrome in children echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[COVID-19 associated multi-system inflammatory syndrome in children other imaging findings|Other Imaging Findings]] | [[COVID-19 associated multi-system inflammatory syndrome in children other diagnostic studies|Other Diagnostic Studies]]
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| ==Treatment==
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| [[COVID-19 associated multi-system inflammatory syndrome in children medical therapy|Medical Therapy]] | [[COVID-19 associated multi-system inflammatory syndrome in children surgery|Surgery]] | [[COVID-19 associated multi-system inflammatory syndrome in children primary prevention|Primary Prevention]] | [[COVID-19 associated multi-system inflammatory syndrome in children secondary prevention|Secondary Prevention]] | [[COVID-19 associated multi-system inflammatory syndrome in children cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[COVID-19 associated multi-system inflammatory syndrome in children future or investigational therapies|Future or Investigational Therapies]]
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