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__NOTOC__ | __NOTOC__ | ||
== | ==COVID-19 associated multi-system inflammatory syndrome in children== | ||
==[[ | {{CMG}}; {{AE}} [..] | ||
{{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 <br> | |||
==[[COVID-19 associated multi-system inflammatory syndrome in children|Overview]]== | |||
==[[ | ==[[COVID-19 associated multi-system inflammatory syndrome in children|Historical Perspective]]== | ||
==[[ | ==[[COVID-19 associated multi-system inflammatory syndrome in children|Classification]]== | ||
==[[ | ==[[COVID-19 associated multi-system inflammatory syndrome in children|Pathophysiology]]== | ||
==[[ | ==[[COVID-19 associated multi-system inflammatory syndrome in children|Causes]]== | ||
==[[ | ==[[COVID-19 associated multi-system inflammatory syndrome in children|Differentiating COVID-19 associated multi-system inflammatory syndrome in children from other diseases]]== | ||
: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]]. | |||
*[[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> | |||
==[[ | *[[toxic shock syndrome]] | ||
==[[COVID-19 associated multi-system inflammatory syndrome in children epidemiology and demographics|Epidemiology and Demographics]]== | |||
==[[ | ==[[COVID-19 associated multi-system inflammatory syndrome in childrenrisk factors|Risk Factors]]== | ||
==[[ | ==[[COVID-19 associated multi-system inflammatory syndrome in children screening|Screening]]== | ||
==[[COVID-19 associated multi-system inflammatory syndrome in children natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | |||
==Diagnosis== | ==Diagnosis== | ||
[[ | ==WHO preliminary case definition== | ||
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>: | |||
*#Rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs (oral, hands or feet). | |||
*#Hypotension or shock. | |||
*#Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated Troponin/NT-proBNP), | |||
*#Evidence of coagulopathy (by PT, PTT, elevated d-Dimers). | |||
*#Acute gastrointestinal problems (diarrhea, vomiting, or abdominal pain). | |||
AND | |||
*Elevated markers of inflammation such as [[ESR]], [[C-reactive protein]], or [[procalcitonin]]. | |||
AND | |||
*No other obvious microbial cause of inflammation, including bacterial [[sepsis]], staphylococcal or streptococcal shock syndromes. | |||
AND | |||
*Evidence of COVID-19 (RT-PCR, antigen test or [[serology]] positive), or likely contact with patients with COVID-19. | |||
[[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]] | |||
==Treatment== | ==Treatment== | ||
[[ | [[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]] | ||
Revision as of 05:51, 26 May 2020
COVID-19 associated multi-system inflammatory syndrome in children
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: [..]
Synonyms and keywords: ; (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
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating COVID-19 associated multi-system inflammatory syndrome in children from other diseases
- 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.
- 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. [1]
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
WHO preliminary case definition
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[2]:
- Rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs (oral, hands or feet).
- Hypotension or shock.
- Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated Troponin/NT-proBNP),
- Evidence of coagulopathy (by PT, PTT, elevated d-Dimers).
- Acute gastrointestinal problems (diarrhea, vomiting, or abdominal pain).
AND
- Elevated markers of inflammation such as ESR, C-reactive protein, or procalcitonin.
AND
- No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes.
AND
- Evidence of COVID-19 (RT-PCR, antigen test or serology positive), or likely contact with patients with COVID-19.
History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram |Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies