Multisystem inflammatory syndrome in children with COVID-19: a view from the pathophysiology
Keywords:
Child, COVID-19, SARS-CoV-2, Systemic Inflammatory Response SyndromeAbstract
Introduction: multisystem inflammatory syndrome is an entity associated with SARS-CoV-2 infection in infants, which, although rare, is generally associated with severe manifestations.
Objective: to describe the fundamental aspects of multisystem inflammatory syndrome in children with COVID-19 from the view of its pathophysiological and immunological bases.
Methodological design: a total of 31 bibliographic sources were selected, most of them original articles and reviews, with more than 75 % updating, from the main medical bibliographic bases on the web.
Development: multisystem inflammatory syndrome in children with COVID-19 represents an entity independent of severe acute COVID-19 infection and Kawasaki disease. It is a post-infectious hyperinflammatory phenomenon, where superantigen-type activation could be important in its pathogenesis, leading to the characteristic cytokine storm, endothelial dysfunction, ischemic and thrombotic phenomena, shock and multi-organ dysfunction. They tend to be patients without comorbidities and present fever, skin lesions, conjunctival injection, gastrointestinal symptoms and cardiovascular dysfunction.
Conclusions: the tendency towards severity in these previously healthy patients, who develop a poorly organized immune response, indicates the need to prevent the disease in all children and adolescents, and to give them correct follow-up after 4-6 weeks from the start of the infection.
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