Materiały źródłowe

• #1 Multisystem Inflammatory Syndrome in Children (MIS-C) | IntechOpen

  https://www.intechopen.com/chapters/86668

  The burden of disease caused by the new SARS-CoV-2 coronavirus is focused on adults. […] Reports in April 2020 described a multisystem inflammatory syndrome in children (MIS-C) occurring 2 to 6 weeks after SARS-CoV-2 wave peak. […] The disease can be life threatening, frequently presented as rapid-onset severe organ failure and need for pediatric critical care support. […] Once vaccination against SARS-CoV-2 began, a drop in the incidence of MIS-C happened. […] MIS-C is a rare complication of pediatric COVID-19. It is described in 1 percent of children with confirmed SARS-CoV-2 infection. […] Reports from the United States describe an incidence of 2 per 100,000 infected with COVID-19 under 21 years of age. […] The epidemiology of MIS-C differs from adult SARS-CoV-2 infection. […] MIS-C appears a few weeks after the peak of SARS-COV2 infection.

• #2 Multisystem inflammatory syndrome in children (MIS-C) and neonates (MIS-N) associated with COVID-19: optimizing definition and management | Pediatric Research

  https://www.nature.com/articles/s41390-022-02263-w

  During the SARS-CoV-2-associated infection (COVID-19), pandemic initial reports suggested relative sparing of children inversely related to their age. […] However, a multisystem inflammatory syndrome in children (MIS-C) or paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 emerged involving coronary artery aneurysms, cardiac dysfunction, and multiorgan inflammatory manifestations. […] More recently neonates born to mothers with SARS-CoV-2 infection during pregnancy demonstrated evidence of a multisystem inflammatory syndrome with raised inflammatory markers and multiorgan, especially cardiac dysfunction that has been described as multisystem inflammatory syndrome in neonates (MIS-N). […] There is a variation in definitions and management algorithms for MIS-C and MIS-N.

• #3 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  COVID-19 vaccination remains important for preventing MIS-C. […] This report describes 2023 MIS-C cases and compares them with cases reported earlier in the COVID-19 pandemic. […] Overall MIS-C incidence in 2023 was 0.11 cases per million person-months, representing an 80% decline in incidence compared with that during AprilDecember 2022, and a 98% decrease from the peak of 6.79 early in the COVID-19 pandemic. […] A similar decline in MIS-C incidence and shift to a younger age group in 2022 was reported in England. […] MIS-C continues to occur, but at low rates compared with those observed early in the COVID-19 pandemic. […] The reported 2023 incidence is likely an underestimate because jurisdictional reporting of MIS-C cases with illness onset in 2023 is incomplete, and case counts and incidence might also be affected by the change in case definition that occurred that year.

• #4 Surveillance for multisystem inflammatory syndrome in children — United States, 2023 | Medical Laboratory Observer

  https://www.mlo-online.com/disease/news/53099202/surveillance-for-multisystem-inflammatory-syndrome-in-children-united-states-2023

  MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population, according to a MMWR report. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] Overall MIS-C incidence in 2023 was 0.11 cases per million person-months (95% CI = 0.100.14), representing an 80% decline in incidence compared with that during AprilDecember 2022 (0.56 cases per million person-months; 95% CI = 0.510.62), and a 98% decrease from the peak of 6.79 (95% CI = 6.567.03) early in the COVID-19 pandemic (October 2020April 2021).

• #5 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 26 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. […] MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] MIS-C cases continue to occur but at low rates, making ongoing surveillance valuable.

• #6 Multisystem Inflammatory Syndrome in Children (MIS-C) – HAN

  https://www.chicagohan.org/covid-19/mis-c

  The Council of State and Territorial Epidemiologists (CSTE) and CDC have developed a new CSTE/CDC MIS-C surveillance case definition, corresponding case report form and case report form guidance document to be used starting January 1, 2023. […] In Chicago and nationally, increases in MIS-C cases have been seen 3 to 4 weeks following surges in COVID-19 cases in the community, reflecting the delay between initial SARS-CoV-2 infection and subsequent inflammatory response. […] As of November 30, 2022, approximately 9,000 cases of illness in persons aged 21 years meeting the 2020 CDC MIS-C case definition had been reported in the United States through national MIS-C surveillance COVID-19 vaccination is highly effective in preventing MIS-C, and all age-eligible children should be up-to-date with their vaccination.

• #7

• #8 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  While the incidence rate is linked to the rate of COVID-19 cases, the actual occurrence of post-COVID MIS-C is rare. In the early days of the pandemic, the incidence of MIS-C following COVID-19 infection was about 1 in 3,000-4,000 children and teens. […] Five years after the condition first emerged, as of January 2025, there have been 9,750 cases that meet criteria and 80 deaths among children and teens (CDC, 2024b). […] The most significant risk factor, however, is infection with COVID-19, with 98% of cases having a positive test for SARS-CoV-2 and the other 2% testing negative but having a close contact who is positive (CDC, 2024b). […] Current data indicates that about 80% of MIS-C cases are among unvaccinated children and of the 20% who are vaccinated, 60% are not up to date with boosters and their immunity against COVID-19 has waned (Yousaf et al., 2024).

• #9 Study Offers Insight into Epidemiology of MIS-C Cases

  https://www.hcplive.com/view/study-offers-insight-epidemiology-misc-cases

  A new cross-sectional study has further elucidated the clinical, geographic, and temporal characteristics of cases related to multisystem inflammatory syndrome in children (MIS-C), a newly identified condition arising from the ongoing coronavirus disease 2019 (COVID-19) pandemic. […] The geographical and temporal distributions of MIS-C were then compared with cases of COVID-19 at the national level and by region. […] The national MIS-C incidence per 100,000 persons younger than 21 years was 2.1, with a variance of 0.2-6.3 in states that reported cases. […] Belays team also identified 3 peaks in MIS-C cases which occurred in early May, early August, and December. The first 2 peaks followed the COVID-19 peaks by 2-5 weeks, while the third peak may seem to follow the same pattern. […] As the COVID-19 pandemic spreads, causing a third peak and more sustained transmission across the United States, physicians should maintain a high index of suspicion for MIS-C to promptly diagnose and treat these patients, the investigators wrote.

• #10

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10217079/

  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 cumulative incidence of MIS-C was 3.27 per 100,000 residents between 0 and 18 years of age. […] Our epidemiological study of MIS-C in southern Italy showed unexpectedly overlapping figures with other US studies. […] The purpose of this study was to estimate the Incidence of MIS-C in Apulia, a geographical region located in southern Italy with a population of about four million, evaluating newly identified cases of MIS-C in children 0-18 years of age during the second wave of the pandemic. […] The cumulative incidence of MIS-C was 3.27 per 100,000 residents between 0 and 18 years of age.

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

  https://www.mdpi.com/2227-9067/10/5/766

  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 cumulative incidence of MIS-C was 3.27 per 100,000 residents between 0 and 18 years of age. […] Our epidemiological study of MIS-C in southern Italy showed unexpectedly overlapping figures with other US studies. […] The purpose of this study was to estimate the Incidence of MIS-C in Apulia, a geographical region located in southern Italy with a population of about four million, evaluating newly identified cases of MIS-C in children 0–18 years of age during the second wave of the pandemic. […] During the reporting period, 22 new cases of MIS-C were admitted to five community pediatric departments in Apulia.

• #12 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/MIS-C-Data.aspx

  There were a total of 1,048 reported MIS-C cases in California from March 23, 2020 (when tracking began) to March 13, 2023. […] While overall mortality from MIS-C remains low in California (under 1%), the disease can be severe. Approximately half of children with MIS-C in California were admitted to the ICU. […] The cumulative MIS-C case rate for California is 9.97 per 100,000 persons. Regional differences in case burden may be due to several factors including level of community transmission, health inequities, more awareness and reporting by health care providers, and properties of the virus that we still are learning about. […] About half of children and teens who had MIS-C had no known previous health conditions or „comorbidities” (52%). The other half of children with MIS-C had a known or reported existing medical condition, the most common being reported as „other” and obesity.

• #13 Multisystem inflammatory syndrome in children (MIS-C) in Canada, CCDR 47(11) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-11-november-2021/multisystem-inflammatory-syndrome-children-canada.html

  This article provides a summary of the epidemiology of multisystem inflammatory syndrome in children (MIS-C) cases reported nationally in Canada by provincial and territorial health authorities. […] In Canada, MIS-C is rare, with 269 cases reported to the Public Health Agency of Canada between March 11, 2020 and October 2, 2021. […] The time trend of MIS-C aligns with the incidence rate time trend of COVID-19 reported in children, with a two to six-week lag. […] A total of 269 cases of MIS-C were reported to the Public Health Agency of Canada during the surveillance period. […] The proportion of MIS-C cases among confirmed COVID-19 cases in children aged 19 years and younger was 0.039% in Canada during the surveillance period. […] Multisystem inflammatory syndrome in children was more likely to occur in males than females (p=0.006), with over half (58%) of reported cases in males.

• #14 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2023.38.e225

  There is difference in the incidence of multi-system inflammatory syndrome in children (MIS-C) in patients with different variants of severe acute respiratory syndrome coronavirus 2, however, little is known about the epidemiology in Asian countries. We investigated and compared the epidemiology of the MIS-C during omicron-dominant period with that of previous periods in South Korea. […] A total of 91 cases were assessed to be MIS-C cases. Number of MIS-C cases have increased from six cases during pre-delta period to 66 cases during omicron period, while the incidence rate (the number of MIS-C cases per 100,000 cases of reported coronavirus disease 2019) has decreased from 38.5 cases per 100,000 (95% confidence interval [CI], 14.183.9) during pre-delta period to 1.6 cases per 100,000 (95% CI, 1.22.0) during omicron periods.

• #15 Lower risk of multi-system inflammatory syndrome in Aussie kids with Omicron COVID-19 variant | PAEDS

  https://paeds.org.au/lower-risk-multi-system-inflammatory-syndrome-aussie-kids-omicron-covid-19-variant

  New research from the Paediatric Active Enhanced Disease Surveillance (PAEDS) network shows rates of multi-system inflammatory syndrome in children (MIS-C) also known as paediatric multisystem inflammatory syndrome (PIMS-TS) were significantly lower during the Omicron COVID-19 variant period than during pre-Delta and Delta COVID-19 variant periods. […] PAEDS hospital network sentinel surveillance, which covers more than 80% of tertiary paediatric beds across Australia, identified 107 cases of MIS-C/PIMS-TS in children aged 0-19 years from 1 May 2020 to 30 April 2022. Cases were classified as occurring during three defined periods determined by the dominant COVID-19 variant circulating at the time of COVID-19 infection. […] Of the 107 identified MIS-C/PIMS-TS cases, 5 (5%) occurred during the pre-Delta/ancestral strain period from March 2020 to May 2021, 30 (28%) during the Delta period from June 2021 to November 2021 and 72 (67%) during the Omicron period from December 2021 to April 2022.

• #16 Lower risk of multi-system inflammatory syndrome in Aussie kids with Omicron COVID-19 variant | PAEDS

  https://paeds.org.au/lower-risk-multi-system-inflammatory-syndrome-aussie-kids-omicron-covid-19-variant

  The rate of MIS-C/PIMS-TS in Australian children reduced over time with the identification of each new dominant COVID-19 variant, with 13 cases per 10,000 notified COVID-19 infections during the pre-Delta period, reducing to 5 cases per 10,000 notified COVID-19 infections during the Delta period and decreasing further to 0.8 cases per 10,000 notified COVID-19 infections during the Omicron period. […] These data are similar to literature published from the United Kingdom, Israel and Denmark, where significantly lower rates of MIS-C/PIMS-TS relative to COVID-19 infection were observed during the Omicron period, with the study findings supporting a contention that changes in viral antigens likely contributed to reduction in MIS-C/PIMS-TS incidence. […] MIS-C/PIMS-TS is a rare condition that occurs predominantly in children following COVID-19 infection and can cause inflammation of the heart, lungs, kidneys, brain, skin and eyes. It can be serious and require hospitalisation, with 22% of identified cases in the study requiring ICU admission. […] PAEDS is undertaking surveillance of MIS-C/PIMS-TS in Australia on an ongoing basis, with case data published on the PAEDS website monthly.

• #17

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10217079/

  The prevalence of MIS-C among pediatric subjects with previous SARS-CoV-2 infection was 0.07%. […] Our study showed unexpectedly overlapping figures with some studies conducted in the US. […] The median age of our cohort was 7.54 years, in the lower end of the reported range (7.3-10.8 years) for MIS-C. […] In fact, the number of children 0-18 years with confirmed SARS-CoV-2 infection during the six months considered was 29,585, and the prevalence of MIS-C among pediatric subjects with previous SARS-CoV-2 infection was 0.07%, with a total of 74 cases per 100,000 younger than 18 years. […] The clinical features of MIS-C observed in our patients showed the similarities and differences between MIS-C and Kawasaki Disease outlined in the literature. […] The American College of Rheumatology (ACR) recommends a stepwise approach to the immunomodulatory treatment of MIS-C, with IVIG and moderate to high doses of glucocorticoids. […] The use of anakinra is recommended by ACR in cases of refractory MIS-C despite IVIG and steroids. […] As far as we know, our work represents one of the first epidemiological studies of MIS-C in Europe, showing overlapping data with US studies.

• #18 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Multisystem-Inflammatory-Syndrome-in-Children-(MIS-C).aspx

  Multisystem inflammatory syndrome in children (MIS-C) is a rare multisystem inflammatory condition that affects children adolescents. It is associated with exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and illness with COVID-19. […] In the UK and Europe, the condition is referred to as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS), whereas in the US it is referred to as MIS-C. […] A recent study in the US suggested MIS-C was most likely to occur in children aged 6 to 12. […] Furthermore, the highest prevalence of MIS-C/PIMS-TS seems to be in those with Afro-Caribbean descent, as well as those with African American, Caribbean, and Hispanic ancestry. […] MIS-C/PIMS-TS was first reported in the UK, Italy, and France, and cases were reported during a high prevalence of the COVID-19 epidemic.

• #19 Multisystem Inflammatory Syndrome in Children (MIS-C) | IntechOpen

  https://www.intechopen.com/chapters/86668

  The Omicron wave is described as less severe in adults and with a lower incidence of MIS-C, which was reported worldwide. […] The impact of vaccination appears to influence not only the variant, but also the age at which MIS-C occurs, showing an epidemiological change with age shifting to younger children ( 5 years) who are not vaccinated. […] MIS-C is rare; however, it is a differential diagnosis that should be taken into account in pediatric patients, while there is circulation of SARS-CoV-2 in the world. […] The fall in the incidence of COVID-19, as well as the lower severity and decrease in mortality, was the consequence of the massive vaccination in both adults and children.

• #20 Multisystem inflammatory syndrome in children (MIS-C) in Canada, CCDR 47(11) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-11-november-2021/multisystem-inflammatory-syndrome-children-canada.html

  This article provides a summary of the epidemiology of multisystem inflammatory syndrome in children (MIS-C) cases reported nationally in Canada by provincial and territorial health authorities. […] In Canada, MIS-C is rare, with 269 cases reported to the Public Health Agency of Canada between March 11, 2020 and October 2, 2021. […] The time trend of MIS-C aligns with the incidence rate time trend of COVID-19 reported in children, with a two to six-week lag. […] A total of 269 cases of MIS-C were reported to the Public Health Agency of Canada during the surveillance period. […] The proportion of MIS-C cases among confirmed COVID-19 cases in children aged 19 years and younger was 0.039% in Canada during the surveillance period. […] Multisystem inflammatory syndrome in children was more likely to occur in males than females (p=0.006), with over half (58%) of reported cases in males.

• #21 Clinical profile and outcome of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection: a single-center observational study from South India | Egyptian Pediatric Association Gazette | Full Text

  https://epag.springeropen.com/articles/10.1186/s43054-022-00156-5

  Our study identified that the most commonly affected age group was 6 to 12 years accounting for more than 50% of the study population. This finding was in agreement with other similar published studies. We also noticed that girls were affected more than boys (M: F ratio of 1:1.9). […] The most common presentations were lethargy (69%), poor oral intake (59%), rash (48%), vomiting (39.7%) and conjunctival congestion (39.7%). The presence of rash and conjunctival congestion were proportionately higher with the increasing age of children. Gastrointestinal system involvement was seen in 62% of our study population which was lower than global data of 86% as reported by recent systematic reviews. […] While neurological involvement was seen in up to 48% of cases in some studies, our population had only 5.1% of children presenting with seizures and altered sensorium.

• #22 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection 2023 Case Definition | CDC

  https://ndc.services.cdc.gov/case-definitions/multisystem-inflammatory-syndrome-in-children-mis-c-2023/

  These results corroborate other results demonstrating disproportionate MIS-C burden among Black and Hispanic persons early in the pandemic. […] Position statement 22-ID-02 establishes a standardized case definition for MIS-C associated with SARS-CoV-2 infection for state, local, territorial, and tribal public health departments to use for routine or targeted surveillance.

• #23 Multisystem inflammatory syndrome in children – Wikipedia

  https://en.wikipedia.org/wiki/Multisystem_inflammatory_syndrome_in_children

  Knowledge of this newly described syndrome is evolving rapidly. Its clinical features may appear somewhat similar to Kawasaki disease, a rare disease of unknown origin that typically affects young children, in which blood vessels become inflamed throughout the body. It can also show features of other serious inflammatory conditions of childhood, including toxic shock and macrophage activation syndromes. Nevertheless, it appears to be a separate syndrome. Older children tend to be affected. […] Clusters of new cases have been reported two to six weeks after local peaks in viral transmission. The disease is thought to be driven by a delayed biological mechanism in certain predisposed children. The European Centre for Disease Prevention and Control (ECDC) has rated risk to children in Europe as being 'low’ overall, based on a 'very low’ likelihood of a child developing this 'high impact’ disease. Regarding ethnicity, the condition seems to affect more children of African, Afro-Caribbean, and Hispanic descent, whereas Kawasaki disease affects more of East Asian ancestry. Initial reports regarded children in various parts of Europe and the United States, and it was unclear to what extent the condition had gone unrecognized elsewhere. Reports have since emerged of cases in various other countries around the world.

• #24 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/MIS-C-Data.aspx

  The COVID-19 pandemic has highlighted health disparities and led to a disproportionate number of cases in certain communities, especially communities of color. […] Of the data available, about 68% of MIS-C cases were in the two lowest advantaged quartiles (scoring lowest on the HPI), and about 42% of MIS-C cases were in the least advantaged quartile alone, meaning a large percentage of MIS-C cases were from residents of less advantaged communities. […] In order to get a better picture of the burden of MIS-C in California, health care professionals and hospital infection personnel should report all cases that meet the CDC definition of MIS-C using the COVID-19 Confidential Morbidity Report (CMR) to their local health department (LHD).

• #25 Multisystem inflammatory syndrome in children (MIS-C) cases by vaccination status in California – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39515133/

  Multisystem inflammatory syndrome in children (MIS-C) is a rare condition occurring after SARS-CoV-2 infection in children under 21 years of age. […] Incidence of MIS-C was compared in unvaccinated and Pfizer-BioNTech vaccinated children aged 12-17 and 5-11 years. […] Compared with vaccinated children, the incident rate ratio of MIS-C was higher among unvaccinated children in both the 12-17-year-old group (22.9, 95 % confidence interval [CI]: 10.5-49.8, p 0.0001) and the 5-11-year-old group (3.3, 95 % CI: 1.6-6.7, p = 0.0004). […] While MIS-C is rare, our results suggest that vaccination with the Pfizer-BioNTech vaccine is protective against MIS-C.

• #26 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 26 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. […] MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] MIS-C cases continue to occur but at low rates, making ongoing surveillance valuable.

• #27 Surveillance for multisystem inflammatory syndrome in children — United States, 2023 | Medical Laboratory Observer

  https://www.mlo-online.com/disease/news/53099202/surveillance-for-multisystem-inflammatory-syndrome-in-children-united-states-2023

  MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population, according to a MMWR report. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] Overall MIS-C incidence in 2023 was 0.11 cases per million person-months (95% CI = 0.100.14), representing an 80% decline in incidence compared with that during AprilDecember 2022 (0.56 cases per million person-months; 95% CI = 0.510.62), and a 98% decrease from the peak of 6.79 (95% CI = 6.567.03) early in the COVID-19 pandemic (October 2020April 2021).

• #28

  https://link.springer.com/article/10.1007/s10787-023-01272-3

  In the USA, a recent case-control study showed that the Pfizer BioNTech vaccine is 91% effective in preventing MIS-C among vaccinated individuals aged 12-18 years. […] In conclusion, although MIS-C is a severe disease that should be monitored, it is clear that the risks posed by the SARS-CoV-2 RNA vaccine are far outweighed by its benefits.

• #29 Asymptomatic SARS-COV2 Infection or COVID-19 vaccination effect for severe multisystem inflammatory syndrome in a 6-year-old girl: case report and review of the literature | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01758-y

  In fact, a US multicenter case-control investigation showed that MIS-C was 84% less probable in children 5 years old after two doses of Pfizer-BioNTech vaccine. […] Another French population-based study revealed that MIS-C affected mostly unvaccinated patients, whereas in children with at least one dose of vaccine, its incidence was reduced by 91%. […] Moreover, during the Delta wave, the Pfizer-BioNTech vaccine was found to be protective for MIS-C in 94% of children. […] Vaccinated children can still develop MIS-C although less frequently and in milder forms, as demonstrated by the 20% higher rate of ICU admission of unvaccinated patients. […] Nowadays, it is still not understood whether MIS-C can be secondary to vaccination or to a recent and often not recognized Sars-Cov2 infection.

• #30 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 26 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. […] MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] MIS-C cases continue to occur but at low rates, making ongoing surveillance valuable.

• #31 Multisystem inflammatory syndrome in children (MIS-C) in Canada, CCDR 47(11) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-11-november-2021/multisystem-inflammatory-syndrome-children-canada.html

  Nearly all (99%) of MIS-C cases required hospitalization, with 36% requiring intensive care unit admission. […] Cases of MIS-C in Canada are rare; however, when illness does occur it is severe, with nearly all cases requiring hospitalization and one third requiring admission to the intensive care unit. […] The time trend of MIS-C aligns with the time trend of the incidence of COVID-19 in children, with a two- to six-week lag. […] In Canada, MIS-C is more likely to occur in males than females.

• #32 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  MIS-C cases have a direct impact on healthcare as a system as well. Around 60% of children presenting to the emergency department with MIS-C are admitted to the hospital and spend an average of five days (Encinosa et al., 2023). […] The average cost of an MIS-C related hospitalization is about $25,644 (Encinosa et al., 2023). […] The mortality rate from MIS-C is between 1%-3% which is higher than other systemic hyperinflammatory conditions like Kawasaki Disease. In contrast to COVID-19, which has a higher mortality rate for children with comorbid conditions, deaths from MIS-C are most often in children without comorbid conditions (Lee Hsueh, 2023; Zuccotti et al., 2023). […] To diagnose MIS-C, the CDC provides specific clinical criteria. […] Clinical criteria for MIS-C as defined by the CDC include (CDC, 2023): Age 21 years, Fever for 1 day, Multisystem organ involvement, Laboratory evidence of inflammation, Clinical severity requiring hospitalization, Positive SARS-CoV-2 antigen/antibody test and/or evidence of COVID-19 exposure within 4 weeks of the onset of symptoms.

• #33 Surveillance for multisystem inflammatory syndrome in children — United States, 2023 | Medical Laboratory Observer

  https://www.mlo-online.com/disease/news/53099202/surveillance-for-multisystem-inflammatory-syndrome-in-children-united-states-2023

  Among the 117 MIS-C patients with illness onset in 2023, 68 (58%) had no underlying medical conditions; 58 (50%) required intensive care unit (ICU)-level care, 40 (34%) experienced shock, and 31 (27%) experienced cardiac dysfunction. […] Three (3%) patients with MIS-C died in 2023. […] Although 112 (96%) patients were age-eligible for COVID-19 vaccination, only 20 (18%) had documented receipt of any COVID-19 vaccine.

• #34 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/MIS-C-Data.aspx

  There were a total of 1,048 reported MIS-C cases in California from March 23, 2020 (when tracking began) to March 13, 2023. […] While overall mortality from MIS-C remains low in California (under 1%), the disease can be severe. Approximately half of children with MIS-C in California were admitted to the ICU. […] The cumulative MIS-C case rate for California is 9.97 per 100,000 persons. Regional differences in case burden may be due to several factors including level of community transmission, health inequities, more awareness and reporting by health care providers, and properties of the virus that we still are learning about. […] About half of children and teens who had MIS-C had no known previous health conditions or „comorbidities” (52%). The other half of children with MIS-C had a known or reported existing medical condition, the most common being reported as „other” and obesity.

• #35 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  MIS-C cases have a direct impact on healthcare as a system as well. Around 60% of children presenting to the emergency department with MIS-C are admitted to the hospital and spend an average of five days (Encinosa et al., 2023). […] The average cost of an MIS-C related hospitalization is about $25,644 (Encinosa et al., 2023). […] The mortality rate from MIS-C is between 1%-3% which is higher than other systemic hyperinflammatory conditions like Kawasaki Disease. In contrast to COVID-19, which has a higher mortality rate for children with comorbid conditions, deaths from MIS-C are most often in children without comorbid conditions (Lee Hsueh, 2023; Zuccotti et al., 2023). […] To diagnose MIS-C, the CDC provides specific clinical criteria. […] Clinical criteria for MIS-C as defined by the CDC include (CDC, 2023): Age 21 years, Fever for 1 day, Multisystem organ involvement, Laboratory evidence of inflammation, Clinical severity requiring hospitalization, Positive SARS-CoV-2 antigen/antibody test and/or evidence of COVID-19 exposure within 4 weeks of the onset of symptoms.

• #36 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/MIS-C-Data.aspx

  There were a total of 1,048 reported MIS-C cases in California from March 23, 2020 (when tracking began) to March 13, 2023. […] While overall mortality from MIS-C remains low in California (under 1%), the disease can be severe. Approximately half of children with MIS-C in California were admitted to the ICU. […] The cumulative MIS-C case rate for California is 9.97 per 100,000 persons. Regional differences in case burden may be due to several factors including level of community transmission, health inequities, more awareness and reporting by health care providers, and properties of the virus that we still are learning about. […] About half of children and teens who had MIS-C had no known previous health conditions or „comorbidities” (52%). The other half of children with MIS-C had a known or reported existing medical condition, the most common being reported as „other” and obesity.

• #37 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Continued reporting of MIS-C cases to jurisdictional health departments is important to monitor trends and patients demographic and clinical characteristics. […] MIS-C patients with illness onset in 2023 were predominantly unvaccinated children and those whose vaccine-induced immunity had likely waned. […] CDC recommends that all children aged 6 months stay up to date with COVID-19 vaccination to protect against serious COVID-19 illness and complications, including MIS-C.

• #38 MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children | RheumNow

  https://rheumnow.com/news/mmwr-vaccination-and-multisystem-inflammatory-syndrome-children

  Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 26 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. The current MMWR report shows that MIS-C case numbers have decreased by 98% since 2021. […] MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population. […] In May 2020, CDC created an MIS-C case definition and established a passive national surveillance system for voluntary case reporting by state and local health departments. […] In 2022, CDC and the Council of State and Territorial Epidemiologists (CSTE) created a new surveillance case definition that went into effect on January 1, 2023.

• #39 Multisystem Inflammatory Syndrome in Children (MIS-C) – HAN

  https://www.chicagohan.org/covid-19/mis-c

  The Council of State and Territorial Epidemiologists (CSTE) and CDC have developed a new CSTE/CDC MIS-C surveillance case definition, corresponding case report form and case report form guidance document to be used starting January 1, 2023. […] In Chicago and nationally, increases in MIS-C cases have been seen 3 to 4 weeks following surges in COVID-19 cases in the community, reflecting the delay between initial SARS-CoV-2 infection and subsequent inflammatory response. […] As of November 30, 2022, approximately 9,000 cases of illness in persons aged 21 years meeting the 2020 CDC MIS-C case definition had been reported in the United States through national MIS-C surveillance COVID-19 vaccination is highly effective in preventing MIS-C, and all age-eligible children should be up-to-date with their vaccination.

• #40 Multisystem Inflammatory Syndrome In Children (MIS-C) – MN Dept. of Health

  https://www.health.state.mn.us/diseases/misc/index.html

  MIS-C stands for multisystem inflammatory syndrome in children, a rare and serious inflammatory syndrome that affects children and young adults. […] MIS-C is very rare, and we do not know yet exactly what causes it. […] The Council of State and Territorial Epidemiologists (CSTE) and CDC have developed a standardized surveillance case definition for multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection, effective January 1, 2023.

• #41 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/MIS-C-Data.aspx

  The COVID-19 pandemic has highlighted health disparities and led to a disproportionate number of cases in certain communities, especially communities of color. […] Of the data available, about 68% of MIS-C cases were in the two lowest advantaged quartiles (scoring lowest on the HPI), and about 42% of MIS-C cases were in the least advantaged quartile alone, meaning a large percentage of MIS-C cases were from residents of less advantaged communities. […] In order to get a better picture of the burden of MIS-C in California, health care professionals and hospital infection personnel should report all cases that meet the CDC definition of MIS-C using the COVID-19 Confidential Morbidity Report (CMR) to their local health department (LHD).

• #42 Multisystem Inflammatory Syndrome in Children (MIS-C) – HAN

  https://www.chicagohan.org/covid-19/mis-c

  All health care providers should maintain a high index of suspicion for MIS-C. […] Suspected cases of MIS-C should be referred immediately to a tertiary care center with a pediatric intensive care unit (PICU). […] Tertiary care centers are asked to consider a collaborative approach in the management of these patients by convening a multispecialty committee (comprised of pediatric critical care, cardiology, hematology, infectious disease, and rheumatology/immunology) that provides coordinated clinical care guidance for each patient while (1) confirming patients meet the case definition, and (2) ensuring that appropriate diagnostic and treatment resources are readily available for this patient population. […] Hospital infection preventionists should be notified immediately upon recognition of patients meeting case definition to initiate public health reporting.

• #43 Brief report: Using syndromic surveillance to monitor MIS-C associated with COVID-19 in Military Health System beneficiaries | Health.mil

  https://www.health.mil/News/Articles/2022/03/01/Brief-Using-MSMR

  In an effort to detect potential cases of MIS-C in the Military Health System (MHS), the Armed Forces Health Surveillance Division (AFHSD) used the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), a syndromic surveillance system which uses outpatient data to monitor trends and increases in health care encounters that may represent changes in the incidence of disease. Users of ESSENCE employ the system to analyze MHS clinical data sources in near real-time, including diagnosis codes, free text chief complaint or reason-for-visit data fields, reportable medical events (RME), laboratory and radiology data, and prescription drug information to develop a picture of disease syndromes based on health care encounters. […] The AFHSD used ESSENCE to create a query based on the case definition of MIS-C developed by the CDC to identify potential MIS-C cases. The query included MIS-C-related International Classification of Diseases, 10th Revision (ICD-10) diagnosis codes and free text chief complaint and reason-for-visit data fields from records of outpatient medical encounters for health care beneficiaries of the MHS 20 years old or younger who sought care between Oct. 19, 2020 and March 12, 2021. The query was adapted from the CDC-developed syndromic surveillance query, but the AFHSD query was modified to exclude those codes which are not present in AFHSD ESSENCE (Z86.16 [personal history of COVID-19] and Z20.822 [exposure to COVID-19 or SARS-CoV-2 infection]). The AFHSD-developed query selected ICD-10 codes in any diagnostic position in the electronic medical record for any outpatient encounter during the study period. Chief complaints were retrieved from patients’ „reason for visit” free text field for each health encounter.

• #44

  https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19

  Recently, however, reports from Europe and North America have described clusters of children and adolescents requiring admission to intensive care units with a multisystem inflammatory condition with some features similar to those of Kawasaki disease and toxic shock syndrome. […] Initial hypotheses are that this syndrome may be related to COVID-19 based on initial laboratory testing showing positive serology in a majority of patients. […] It is essential to characterize this syndrome and its risk factors, to understand causality, and describe treatment interventions. […] There is therefore an urgent need for collection of standardized data describing clinical presentations, severity, outcomes, and epidemiology. […] WHO has developed a preliminary case definition and case report form for multisystem inflammatory disorder in children and adolescents. […] The preliminary case definition reflects the clinical and laboratory features observed in children reported to date, and serves to identify suspected or confirmed cases both for the purpose of providing treatment and for provisional reporting and surveillance.

• #45 Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (spring 2021 update) | Canadian Paediatric Society

  https://cps.ca/documents/position/pims

  Children comprise only a small percentage of cases of acute SARS-CoV-2 infection and usually have mild or moderate symptoms or are asymptomatic. However, a post-infectious inflammatory syndrome in paediatric patients temporally associated with COVID-19 has been described, and cases have been reported from across Canada and worldwide. […] Several names and case definitions have been used to describe this syndrome, including paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS-TS) and multisystem inflammatory syndrome in children (MIS-C). […] The syndrome is currently under active surveillance by the Canadian Paediatric Surveillance Program (CPSP), and cases suspected by paediatricians in Canada should be reported. […] Initial reports of this syndrome arose from some of the areas hardest hit by COVID-19, where affected children appeared to develop signs or symptoms approximately 2 to 6 weeks following the peak of SARS-CoV-2 cases in their communities.

• #46 Lower risk of multi-system inflammatory syndrome in Aussie kids with Omicron COVID-19 variant | PAEDS

  https://paeds.org.au/lower-risk-multi-system-inflammatory-syndrome-aussie-kids-omicron-covid-19-variant

  The rate of MIS-C/PIMS-TS in Australian children reduced over time with the identification of each new dominant COVID-19 variant, with 13 cases per 10,000 notified COVID-19 infections during the pre-Delta period, reducing to 5 cases per 10,000 notified COVID-19 infections during the Delta period and decreasing further to 0.8 cases per 10,000 notified COVID-19 infections during the Omicron period. […] These data are similar to literature published from the United Kingdom, Israel and Denmark, where significantly lower rates of MIS-C/PIMS-TS relative to COVID-19 infection were observed during the Omicron period, with the study findings supporting a contention that changes in viral antigens likely contributed to reduction in MIS-C/PIMS-TS incidence. […] MIS-C/PIMS-TS is a rare condition that occurs predominantly in children following COVID-19 infection and can cause inflammation of the heart, lungs, kidneys, brain, skin and eyes. It can be serious and require hospitalisation, with 22% of identified cases in the study requiring ICU admission. […] PAEDS is undertaking surveillance of MIS-C/PIMS-TS in Australia on an ongoing basis, with case data published on the PAEDS website monthly.

• #47 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  COVID-19 vaccination remains important for preventing MIS-C. […] This report describes 2023 MIS-C cases and compares them with cases reported earlier in the COVID-19 pandemic. […] Overall MIS-C incidence in 2023 was 0.11 cases per million person-months, representing an 80% decline in incidence compared with that during AprilDecember 2022, and a 98% decrease from the peak of 6.79 early in the COVID-19 pandemic. […] A similar decline in MIS-C incidence and shift to a younger age group in 2022 was reported in England. […] MIS-C continues to occur, but at low rates compared with those observed early in the COVID-19 pandemic. […] The reported 2023 incidence is likely an underestimate because jurisdictional reporting of MIS-C cases with illness onset in 2023 is incomplete, and case counts and incidence might also be affected by the change in case definition that occurred that year.

• #48 CDC: Cases of MIS-C After COVID Still Occurring in U.S. Kids | MedPage Today

  https://www.medpagetoday.com/pediatrics/generalpediatrics/109202

  „MIS-C patients with illness onset in 2023 were predominantly unvaccinated children and those whose vaccine-induced immunity had likely waned,” Yousaf and colleagues wrote. „COVID-19 vaccination remains an important tool for preventing MIS-C.” […] Yousaf and colleagues acknowledged that 2023 incidence is „likely an underestimate” because jurisdictional reporting of MIS-C cases with illness onset in 2023 was incomplete, and because case counts might have been affected by a change in case definition.

• #49 MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children | RheumNow

  https://rheumnow.com/news/mmwr-vaccination-and-multisystem-inflammatory-syndrome-children

  Overall MIS-C incidence in 2023 was 0.11 cases per million person-months (95% CI = 0.100.14), representing an 80% decline in incidence compared with that during AprilDecember 2022 (0.56 cases per million person-months; 95% CI = 0.510.62), and a 98% decrease from the peak of 6.79 (95% CI = 6.567.03) early in the COVID-19 pandemic (October 2020April 2021). […] MIS-C continues to occur, but at low rates compared with those observed early in the COVID-19 pandemic. […] The reported 2023 incidence is likely an underestimate because jurisdictional reporting of MIS-C cases with illness onset in 2023 is incomplete, and case counts and incidence might also be affected by the change in case definition that occurred that year. […] Clinicians should recognize that MIS-C might occur, especially during and after periods of increased COVID-19 activity, and should be familiar with treatment guidelines. […] COVID-19 vaccination remains an important tool for preventing MIS-C. […] CDC recommends that all children aged 6 months stay up to date with COVID-19 vaccination to protect against serious COVID-19 illness and complications, including MIS-C.

• #50 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Multisystem-Inflammatory-Syndrome-in-Children-(MIS-C).aspx

  Multisystem inflammatory syndrome in children (MIS-C) is a rare multisystem inflammatory condition that affects children adolescents. It is associated with exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and illness with COVID-19. […] In the UK and Europe, the condition is referred to as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS), whereas in the US it is referred to as MIS-C. […] A recent study in the US suggested MIS-C was most likely to occur in children aged 6 to 12. […] Furthermore, the highest prevalence of MIS-C/PIMS-TS seems to be in those with Afro-Caribbean descent, as well as those with African American, Caribbean, and Hispanic ancestry. […] MIS-C/PIMS-TS was first reported in the UK, Italy, and France, and cases were reported during a high prevalence of the COVID-19 epidemic.

• #51 Multisystem inflammatory syndrome in 1.2 million children: longitudinal cohort study of risk factors | Pediatric Research

  https://www.nature.com/articles/s41390-023-02633-y

  We identified patient characteristics associated with an increased risk of developing MIS-C. […] We conducted a longitudinal cohort study of 1,195,327 patients aged 0-19 years between 2006 and 2021, including the first two waves of the pandemic (February 25-August 22, 2020 and August 23, 2020-March 31, 2021). […] Among 1,195,327 children, 84 developed MIS-C, 107 Kawasaki disease, and 330 other Covid-19 complications during the first year of the pandemic. […] Prepandemic hospitalizations for metabolic disorders (RR 11.3, 95% CI 5.6-122.6), atopic conditions (RR 3.34, 95% CI 1.60-6.97), and cancer (RR 8.11, 95% CI 1.13-58.3) were strongly associated with the risk of MIS-C, compared with no exposure. […] Children with pre-existing morbidity have a considerably elevated risk of MIS-C. […] In this study, prepandemic hospitalizations for metabolic disorders, atopic conditions, and cancer were associated with an elevated risk of MIS-C. […] Birth characteristics and family history of maternal morbidity were not, however, associated with MIS-C. […] The findings indicate that childhood morbidity may be more important for the development of MIS-C than birth characteristics or maternal morbidity.

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

  https://www.mdpi.com/2227-9067/10/5/766

  The cumulative incidence of MIS-C was 3.27 per 100,000 residents between 0 and 18 years of age. […] The most affected age group was 6–10 years, with a cumulative incidence of 5.67 per 100,000 residents aged 0–18 years. […] In our cohort, gastrointestinal, mucocutaneous, and cardiac involvement were the most common clinical features. […] A significant proportion of patients required intensive care (31–85%), and some of them needed mechanical ventilation and extracorporeal membrane oxygenation. […] Our study showed unexpectedly overlapping figures with some studies conducted in the US. […] The median age of our cohort was 7.54 years, in the lower end of the reported range (7.3–10.8 years) for MIS-C. […] The prevalence of MIS-C among pediatric subjects with previous SARS-CoV-2 infection was 0.07%.

• #53 Multisystem inflammatory syndrome in children – Wikipedia

  https://en.wikipedia.org/wiki/Multisystem_inflammatory_syndrome_in_children

  Knowledge of this newly described syndrome is evolving rapidly. Its clinical features may appear somewhat similar to Kawasaki disease, a rare disease of unknown origin that typically affects young children, in which blood vessels become inflamed throughout the body. It can also show features of other serious inflammatory conditions of childhood, including toxic shock and macrophage activation syndromes. Nevertheless, it appears to be a separate syndrome. Older children tend to be affected. […] Clusters of new cases have been reported two to six weeks after local peaks in viral transmission. The disease is thought to be driven by a delayed biological mechanism in certain predisposed children. The European Centre for Disease Prevention and Control (ECDC) has rated risk to children in Europe as being 'low’ overall, based on a 'very low’ likelihood of a child developing this 'high impact’ disease. Regarding ethnicity, the condition seems to affect more children of African, Afro-Caribbean, and Hispanic descent, whereas Kawasaki disease affects more of East Asian ancestry. Initial reports regarded children in various parts of Europe and the United States, and it was unclear to what extent the condition had gone unrecognized elsewhere. Reports have since emerged of cases in various other countries around the world.

• #54 Multisystem inflammatory syndrome in children (MIS-C) and neonates (MIS-N) associated with COVID-19: optimizing definition and management | Pediatric Research

  https://www.nature.com/articles/s41390-022-02263-w

  Multisystem inflammatory system in children and neonates (MIS-C and MIS-N) post COVID require an internationally recognized consensus definition and international datasets to improve management and plan future clinical trials. […] Further understanding of the pathophysiology of MIS-C and MIS-N will allow future targeted therapies to prevent and limit clinical sequelae. […] SARS-CoV-2 infection in infants and children has been documented in 9,452,491 children in the US (as of January 12, 2022) and most cases are asymptomatic or cause mild clinical illness. […] On May 14, 2020, Centers for Disease Control and Prevention (CDC) published an online Health Advisory that summarized the manifestations and labeled this condition as an MIS-C related to COVID-19. […] By January 3, 2021, a total of 6431 MIS-C patients had been reported in the US with 55 deaths.

• #55 Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (spring 2021 update) | Canadian Paediatric Society

  https://cps.ca/documents/position/pims

  Many case series have suggested that a disproportionally high number of Afro-American, Afro-Caribbean, and Hispanic children are affected by PIMS/MIS-C. […] It is unclear whether this la is attributable to differences in genetic, socioeconomic, or exposure risk factors. […] Patients with PIMS/MIS-C appear to be at risk for developing coronary artery aneurysms. […] When PIMS/MIS-C is diagnosed and treated promptly, most children have favourable outcomes.

• #56 Multisystem inflammatory syndrome in children – Wikipedia

  https://en.wikipedia.org/wiki/Multisystem_inflammatory_syndrome_in_children

  Knowledge of this newly described syndrome is evolving rapidly. Its clinical features may appear somewhat similar to Kawasaki disease, a rare disease of unknown origin that typically affects young children, in which blood vessels become inflamed throughout the body. It can also show features of other serious inflammatory conditions of childhood, including toxic shock and macrophage activation syndromes. Nevertheless, it appears to be a separate syndrome. Older children tend to be affected. […] Clusters of new cases have been reported two to six weeks after local peaks in viral transmission. The disease is thought to be driven by a delayed biological mechanism in certain predisposed children. The European Centre for Disease Prevention and Control (ECDC) has rated risk to children in Europe as being 'low’ overall, based on a 'very low’ likelihood of a child developing this 'high impact’ disease. Regarding ethnicity, the condition seems to affect more children of African, Afro-Caribbean, and Hispanic descent, whereas Kawasaki disease affects more of East Asian ancestry. Initial reports regarded children in various parts of Europe and the United States, and it was unclear to what extent the condition had gone unrecognized elsewhere. Reports have since emerged of cases in various other countries around the world.

• #57 Multisystem inflammatory syndrome in children (MIS-C) and COVID-19 – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mis-c-in-kids-covid-19/symptoms-causes/syc-20502550

  The exact cause of MIS-C is not known yet. Many children with MIS-C have had a recent infection with the COVID-19 virus. Some may have a current infection with the virus. […] One idea of a possible cause of MIS-C is that infection with the virus that causes COVID-19, either current or earlier, causes the immune system to overreact.

• #58 Multisystem inflammatory syndrome in 1.2 million children: longitudinal cohort study of risk factors | Pediatric Research

  https://www.nature.com/articles/s41390-023-02633-y

  We identified patient characteristics associated with an increased risk of developing MIS-C. […] We conducted a longitudinal cohort study of 1,195,327 patients aged 0-19 years between 2006 and 2021, including the first two waves of the pandemic (February 25-August 22, 2020 and August 23, 2020-March 31, 2021). […] Among 1,195,327 children, 84 developed MIS-C, 107 Kawasaki disease, and 330 other Covid-19 complications during the first year of the pandemic. […] Prepandemic hospitalizations for metabolic disorders (RR 11.3, 95% CI 5.6-122.6), atopic conditions (RR 3.34, 95% CI 1.60-6.97), and cancer (RR 8.11, 95% CI 1.13-58.3) were strongly associated with the risk of MIS-C, compared with no exposure. […] Children with pre-existing morbidity have a considerably elevated risk of MIS-C. […] In this study, prepandemic hospitalizations for metabolic disorders, atopic conditions, and cancer were associated with an elevated risk of MIS-C. […] Birth characteristics and family history of maternal morbidity were not, however, associated with MIS-C. […] The findings indicate that childhood morbidity may be more important for the development of MIS-C than birth characteristics or maternal morbidity.

• #59 Clinical characteristics and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in Iran: A multicenter study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274104

  Clinical characteristics and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in Iran: A multicenter study […] This study aimed to assess the clinical characteristics, treatment and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 in five different geographical regions of Iran. […] In total 225 patients with median age of 55 (2696) months were included that 59.56% boys. 57.33% were admitted to the PICU with a median of 7 days (410). 95.56% of patients were discharged with recovery and the rest died. All of the patients in our study were included based on the MIS-C criteria. However, some patients had Kawasaki symptoms, so we compared the clinical and epidemiological characteristics of the two groups. The most common comorbidity was obesity (24.86%). Most patients tested for COVID-19 and about 60% of the patients had a positive test by serology or reverse transcription-polymerase chain reaction (RT-PCR). Gastrointestinal (88.89%) and hematologic signs (84.44%) were most common. Most drugs used in patients were IVIG and steroids. 88.07% and 61.29% of the patients had at least one problem in echocardiography and lung CT, respectively.

• #60 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/MIS-C-Data.aspx

  There were a total of 1,048 reported MIS-C cases in California from March 23, 2020 (when tracking began) to March 13, 2023. […] While overall mortality from MIS-C remains low in California (under 1%), the disease can be severe. Approximately half of children with MIS-C in California were admitted to the ICU. […] The cumulative MIS-C case rate for California is 9.97 per 100,000 persons. Regional differences in case burden may be due to several factors including level of community transmission, health inequities, more awareness and reporting by health care providers, and properties of the virus that we still are learning about. […] About half of children and teens who had MIS-C had no known previous health conditions or „comorbidities” (52%). The other half of children with MIS-C had a known or reported existing medical condition, the most common being reported as „other” and obesity.

• #61 Multisystem inflammatory syndrome in 1.2 million children: longitudinal cohort study of risk factors | Pediatric Research

  https://www.nature.com/articles/s41390-023-02633-y

  We identified patient characteristics associated with an increased risk of developing MIS-C. […] We conducted a longitudinal cohort study of 1,195,327 patients aged 0-19 years between 2006 and 2021, including the first two waves of the pandemic (February 25-August 22, 2020 and August 23, 2020-March 31, 2021). […] Among 1,195,327 children, 84 developed MIS-C, 107 Kawasaki disease, and 330 other Covid-19 complications during the first year of the pandemic. […] Prepandemic hospitalizations for metabolic disorders (RR 11.3, 95% CI 5.6-122.6), atopic conditions (RR 3.34, 95% CI 1.60-6.97), and cancer (RR 8.11, 95% CI 1.13-58.3) were strongly associated with the risk of MIS-C, compared with no exposure. […] Children with pre-existing morbidity have a considerably elevated risk of MIS-C. […] In this study, prepandemic hospitalizations for metabolic disorders, atopic conditions, and cancer were associated with an elevated risk of MIS-C. […] Birth characteristics and family history of maternal morbidity were not, however, associated with MIS-C. […] The findings indicate that childhood morbidity may be more important for the development of MIS-C than birth characteristics or maternal morbidity.

• #62 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with SARS-CoV-2 Infection 2023 Case Definition | CDC

  https://ndc.services.cdc.gov/case-definitions/multisystem-inflammatory-syndrome-in-children-mis-c-2023/

  Multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a severe delayed hyperinflammatory condition in children and adolescents occurring 26 weeks after antecedent SARS-CoV-2 infection. […] Although acute SARS-CoV-2 infection in children is generally mild or asymptomatic, associated MIS-C is characterized by fever, elevated laboratory markers of systemic inflammation, and multiple organ system dysfunction including cardiovascular, mucocutaneous, gastrointestinal, hematologic, neurologic, and renal involvement. […] Using the case definition released by the Centers for Disease Control and Prevention (CDC) in May 2020, incidence of MIS-C in seven U.S. jurisdictions during AprilJune 2020 was estimated to be 5.1 cases per million person-months or 316 cases per million SARS-CoV-2 infections among persons aged 11.

• #63 Multisystem Inflammatory Syndrome (MIS) Associated with COVID-19 – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/multisystem-inflammatory-syndrome-in-children-mis-c/

  Multisystem Inflammatory Syndrome (MIS) is a rare but serious condition associated with SARS-CoV-2 infection (the virus that causes COVID-19). […] MIS can affect children, and this is known as Multisystem Inflammatory Syndrome in Children (MIS-C). […] MIS is seen in children and adults after recent infection with SARS-CoV-2 (the virus that causes COVID-19), typically within the previous 26 weeks. […] Symptoms of MIS can appear weeks after infection with SARS-CoV-2. Typically, MIS symptoms appear within two to six weeks after infection. […] Most children with MIS-C get better quickly and do not have long-term health issues.

• #64 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2023.38.e225

  Omicron period were associated with less severe clinical manifestation compared to pre-delta and delta periods. Although incidence rate of MIS-C was lower for the omicron period than pre-delta and delta periods, number of patients reported with MIS-C may pose a substantial clinical burden. […] The main finding of this study was that the incidence of MIS-C during omicron period was lower, while the severity tended to be less severe than that of previous strain-dominant periods. […] Despite these limitations, our data indicate that the omicron variant is associated with less severe MIS-C in Korean children, however, the number of cases can increase due to increased number of SARS-CoV-2 infection.

• #65

  https://link.springer.com/article/10.1007/s10787-023-01272-3

  In April 2020, UK health officials reported the first cases of what would become known as multisystem inflammatory syndrome in children (MIS-C). […] Symptoms of MIS-C include fever, abdominal pain, vomiting, diarrhea, and rash. In severe cases, MIS-C can cause organ damage and even death. […] The emergence of the more contagious Omicron variant has presented us with numerous difficulties, notably its increased transmissibility, reduced effectiveness even after vaccination, and waning efficacy over time. […] Studies have shown that the effectiveness of the Omicron vaccine decreases with time; however, the Omicron wave resulted in significantly milder acute cases. […] Studies carried out in various countries have found that the prevalence of MIS-C is significantly decreasing but remains a serious complication of SARS-CoV-2 infection.

• #66 Multisystem inflammatory syndrome in children (MIS-C) cases by vaccination status in California – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39515133/

  Multisystem inflammatory syndrome in children (MIS-C) is a rare condition occurring after SARS-CoV-2 infection in children under 21 years of age. […] Incidence of MIS-C was compared in unvaccinated and Pfizer-BioNTech vaccinated children aged 12-17 and 5-11 years. […] Compared with vaccinated children, the incident rate ratio of MIS-C was higher among unvaccinated children in both the 12-17-year-old group (22.9, 95 % confidence interval [CI]: 10.5-49.8, p 0.0001) and the 5-11-year-old group (3.3, 95 % CI: 1.6-6.7, p = 0.0004). […] While MIS-C is rare, our results suggest that vaccination with the Pfizer-BioNTech vaccine is protective against MIS-C.

• #67 COVID-19 Vaccine Protects Against Multisystem Inflammatory Syndrome in Childrenlogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na57259/2024/03/22/covid-19-vaccine-protects-against-multisystem-inflammatory

  In 2023, children vaccinated against COVID-19 were less likely to develop MIS-C following infection with SARS-CoV-2. […] Multisystem inflammatory syndrome in children (MIS-C) is a multiorgan inflammatory condition that follows primary or recurrent SARS-CoV-2 infection. […] Rates of MIS-C were highest during the early months of the pandemic; thereafter, reported peaks mirrored COVID-19 activity. […] Now, CDC authors describe 117 children who met the 2023 CDC case definition of MIS-C (with onset in 2023; mean age, 7 years). Overall incidence was 0.11 cases per million person-months, a significant decline from the peak months in 2022 (0.56 per million person-months) and 2020 (6.79 per million person-months). […] Despite 96% of patients being age-eligible, only 18% had received any COVID-19 vaccination.

• #68

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10217079/

  The prevalence of MIS-C among pediatric subjects with previous SARS-CoV-2 infection was 0.07%. […] Our study showed unexpectedly overlapping figures with some studies conducted in the US. […] The median age of our cohort was 7.54 years, in the lower end of the reported range (7.3-10.8 years) for MIS-C. […] In fact, the number of children 0-18 years with confirmed SARS-CoV-2 infection during the six months considered was 29,585, and the prevalence of MIS-C among pediatric subjects with previous SARS-CoV-2 infection was 0.07%, with a total of 74 cases per 100,000 younger than 18 years. […] The clinical features of MIS-C observed in our patients showed the similarities and differences between MIS-C and Kawasaki Disease outlined in the literature. […] The American College of Rheumatology (ACR) recommends a stepwise approach to the immunomodulatory treatment of MIS-C, with IVIG and moderate to high doses of glucocorticoids. […] The use of anakinra is recommended by ACR in cases of refractory MIS-C despite IVIG and steroids. […] As far as we know, our work represents one of the first epidemiological studies of MIS-C in Europe, showing overlapping data with US studies.

• #69 Multisystem inflammatory syndrome in children (MIS-C) and neonates (MIS-N) associated with COVID-19: optimizing definition and management | Pediatric Research

  https://www.nature.com/articles/s41390-022-02263-w

  Multisystem inflammatory system in children and neonates (MIS-C and MIS-N) post COVID require an internationally recognized consensus definition and international datasets to improve management and plan future clinical trials. […] Further understanding of the pathophysiology of MIS-C and MIS-N will allow future targeted therapies to prevent and limit clinical sequelae. […] SARS-CoV-2 infection in infants and children has been documented in 9,452,491 children in the US (as of January 12, 2022) and most cases are asymptomatic or cause mild clinical illness. […] On May 14, 2020, Centers for Disease Control and Prevention (CDC) published an online Health Advisory that summarized the manifestations and labeled this condition as an MIS-C related to COVID-19. […] By January 3, 2021, a total of 6431 MIS-C patients had been reported in the US with 55 deaths.

• #70 Clinical characteristics and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in Iran: A multicenter study | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274104

  Clinical characteristics and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 infection in Iran: A multicenter study […] This study aimed to assess the clinical characteristics, treatment and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 in five different geographical regions of Iran. […] In total 225 patients with median age of 55 (2696) months were included that 59.56% boys. 57.33% were admitted to the PICU with a median of 7 days (410). 95.56% of patients were discharged with recovery and the rest died. All of the patients in our study were included based on the MIS-C criteria. However, some patients had Kawasaki symptoms, so we compared the clinical and epidemiological characteristics of the two groups. The most common comorbidity was obesity (24.86%). Most patients tested for COVID-19 and about 60% of the patients had a positive test by serology or reverse transcription-polymerase chain reaction (RT-PCR). Gastrointestinal (88.89%) and hematologic signs (84.44%) were most common. Most drugs used in patients were IVIG and steroids. 88.07% and 61.29% of the patients had at least one problem in echocardiography and lung CT, respectively.

• #71 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 26 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. […] MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] MIS-C cases continue to occur but at low rates, making ongoing surveillance valuable.

• #72 COVID-19 Vaccine Protects Against Multisystem Inflammatory Syndrome in Childrenlogo-32logo-40logo-60NEJM Journal WatchnejmJW_1L_RGB-b

  https://www.jwatch.org/na57259/2024/03/22/covid-19-vaccine-protects-against-multisystem-inflammatory

  Of the vaccinated children with MIS-C, 60% had received their last vaccination more than a year before their MIS-C diagnosis. […] Three deaths were attributable to MIS-C. […] Although the incidence of MIS-C has decreased significantly since its initial recognition, the children most at risk for this serious, sometimes deadly, condition are those who have not received a COVID-19 vaccine. […] The authors did not explore whether prior infection is also protective against MIS-C. […] COVID-19 vaccination is safe, effective, and recommended for children aged ≥6 months. […] This study provides us with additional information to share with parents who remain unsure about the benefits of COVID-19 vaccination for their children.

• #73 Multisystem inflammatory syndrome in 1.2 million children: longitudinal cohort study of risk factors | Pediatric Research

  https://www.nature.com/articles/s41390-023-02633-y

  We identified patient characteristics associated with an increased risk of developing MIS-C. […] We conducted a longitudinal cohort study of 1,195,327 patients aged 0-19 years between 2006 and 2021, including the first two waves of the pandemic (February 25-August 22, 2020 and August 23, 2020-March 31, 2021). […] Among 1,195,327 children, 84 developed MIS-C, 107 Kawasaki disease, and 330 other Covid-19 complications during the first year of the pandemic. […] Prepandemic hospitalizations for metabolic disorders (RR 11.3, 95% CI 5.6-122.6), atopic conditions (RR 3.34, 95% CI 1.60-6.97), and cancer (RR 8.11, 95% CI 1.13-58.3) were strongly associated with the risk of MIS-C, compared with no exposure. […] Children with pre-existing morbidity have a considerably elevated risk of MIS-C. […] In this study, prepandemic hospitalizations for metabolic disorders, atopic conditions, and cancer were associated with an elevated risk of MIS-C. […] Birth characteristics and family history of maternal morbidity were not, however, associated with MIS-C. […] The findings indicate that childhood morbidity may be more important for the development of MIS-C than birth characteristics or maternal morbidity.

• #74 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/MIS-C-Data.aspx

  The COVID-19 pandemic has highlighted health disparities and led to a disproportionate number of cases in certain communities, especially communities of color. […] Of the data available, about 68% of MIS-C cases were in the two lowest advantaged quartiles (scoring lowest on the HPI), and about 42% of MIS-C cases were in the least advantaged quartile alone, meaning a large percentage of MIS-C cases were from residents of less advantaged communities. […] In order to get a better picture of the burden of MIS-C in California, health care professionals and hospital infection personnel should report all cases that meet the CDC definition of MIS-C using the COVID-19 Confidential Morbidity Report (CMR) to their local health department (LHD).

• #75 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 26 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. […] MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] MIS-C cases continue to occur but at low rates, making ongoing surveillance valuable.

• #76 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  MIS-C cases have a direct impact on healthcare as a system as well. Around 60% of children presenting to the emergency department with MIS-C are admitted to the hospital and spend an average of five days (Encinosa et al., 2023). […] The average cost of an MIS-C related hospitalization is about $25,644 (Encinosa et al., 2023). […] The mortality rate from MIS-C is between 1%-3% which is higher than other systemic hyperinflammatory conditions like Kawasaki Disease. In contrast to COVID-19, which has a higher mortality rate for children with comorbid conditions, deaths from MIS-C are most often in children without comorbid conditions (Lee Hsueh, 2023; Zuccotti et al., 2023). […] To diagnose MIS-C, the CDC provides specific clinical criteria. […] Clinical criteria for MIS-C as defined by the CDC include (CDC, 2023): Age 21 years, Fever for 1 day, Multisystem organ involvement, Laboratory evidence of inflammation, Clinical severity requiring hospitalization, Positive SARS-CoV-2 antigen/antibody test and/or evidence of COVID-19 exposure within 4 weeks of the onset of symptoms.

• #77 Multisystem inflammatory syndrome in children (MIS-C) in Canada, CCDR 47(11) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-11-november-2021/multisystem-inflammatory-syndrome-children-canada.html

  Nearly all (99%) of MIS-C cases required hospitalization, with 36% requiring intensive care unit admission. […] Cases of MIS-C in Canada are rare; however, when illness does occur it is severe, with nearly all cases requiring hospitalization and one third requiring admission to the intensive care unit. […] The time trend of MIS-C aligns with the time trend of the incidence of COVID-19 in children, with a two- to six-week lag. […] In Canada, MIS-C is more likely to occur in males than females.

• #78 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  MIS-C cases have a direct impact on healthcare as a system as well. Around 60% of children presenting to the emergency department with MIS-C are admitted to the hospital and spend an average of five days (Encinosa et al., 2023). […] The average cost of an MIS-C related hospitalization is about $25,644 (Encinosa et al., 2023). […] The mortality rate from MIS-C is between 1%-3% which is higher than other systemic hyperinflammatory conditions like Kawasaki Disease. In contrast to COVID-19, which has a higher mortality rate for children with comorbid conditions, deaths from MIS-C are most often in children without comorbid conditions (Lee Hsueh, 2023; Zuccotti et al., 2023). […] To diagnose MIS-C, the CDC provides specific clinical criteria. […] Clinical criteria for MIS-C as defined by the CDC include (CDC, 2023): Age 21 years, Fever for 1 day, Multisystem organ involvement, Laboratory evidence of inflammation, Clinical severity requiring hospitalization, Positive SARS-CoV-2 antigen/antibody test and/or evidence of COVID-19 exposure within 4 weeks of the onset of symptoms.

• #79 Multisystem Inflammatory Syndrome in Children (MIS-C) – HAN

  https://www.chicagohan.org/covid-19/mis-c

  All health care providers should maintain a high index of suspicion for MIS-C. […] Suspected cases of MIS-C should be referred immediately to a tertiary care center with a pediatric intensive care unit (PICU). […] Tertiary care centers are asked to consider a collaborative approach in the management of these patients by convening a multispecialty committee (comprised of pediatric critical care, cardiology, hematology, infectious disease, and rheumatology/immunology) that provides coordinated clinical care guidance for each patient while (1) confirming patients meet the case definition, and (2) ensuring that appropriate diagnostic and treatment resources are readily available for this patient population. […] Hospital infection preventionists should be notified immediately upon recognition of patients meeting case definition to initiate public health reporting.

• #80 CDC: Cases of MIS-C After COVID Still Occurring in U.S. Kids | MedPage Today

  https://www.medpagetoday.com/pediatrics/generalpediatrics/109202

  Cases of multisystem inflammatory syndrome in children (MIS-C) are still popping up, but at lower rates than those observed early in the COVID-19 pandemic, CDC researchers said. […] In 2023, MIS-C incidence was 0.11 cases per million person-months, representing an 80% decrease in incidence compared with April-December 2022 (0.56 cases per million person-months) and a 98% decrease from the peak of 6.79 early in the pandemic (October 2020-April 2021), reported Anna Yousaf, MD, of the CDC’s National Center for Immunization and Respiratory Diseases, and colleagues. […] „Clinicians should recognize that MIS-C might occur, especially during and after periods of increased COVID-19 activity, and should be familiar with treatment guidelines,” Yousaf and colleagues wrote. „Continued reporting of MIS-C cases to jurisdictional health departments is important to monitor trends and patients’ demographic and clinical characteristics.”

• #81 Multisystem inflammatory syndrome in children (MIS-C) and COVID-19 – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mis-c-in-kids-covid-19/symptoms-causes/syc-20502550

  Multisystem inflammatory syndrome in children (MIS-C) is a group of symptoms linked to swollen, called inflamed, organs or tissues. […] MIS-C was first detected in April 2020. MIS-C is currently linked to coronavirus disease 2019 (COVID-19). Experts are still studying the cause of MIS-C and risk factors for getting it. […] MIS-C is rare. It most often happens within 2 months after having COVID-19. The child may have had a known infection. Or a close contact may have a confirmed infection. […] MIS-C is thought to be a complication of COVID-19. Without early diagnosis and treatment, MIS-C can lead to severe problems with vital organs, such as the heart. In rare cases, MIS-C could lead to permanent damage or even death. […] Children diagnosed with MIS-C are often between the ages of 5 and 11 years old. But cases are reported among children ages 1 to 15. A few cases have also happened in older kids and in babies.

• #82 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  When diagnosing MIS-C, it must be differentiated from other systemic inflammatory disorders and infections that include (Lee Hsueh, 2023; Rabb Kimmel, 2023; Childrens Minnesota, 2024): Kawasaki Disease, Viral infections, Stevens-Johnson Syndrome, Toxic shock syndrome, Systemic juvenile idiopathic arthritis, Bacterial sepsis. […] MIS-C can be very challenging to differentiate from TSS. […] At the present date, there is not any universal protocol for managing MIS-C and treatment for it consists of expert opinion and support of affected organ systems. […] The current recommendation is for all children ages 6 months and older to receive an initial COVID-19 vaccine and at least 1 updated vaccine (CDC, 2024c). […] Parents and children should be educated about the significantly decreased risk of MIS-C for children who are fully up to date on COVID-19 vaccines (Yousaf et al., 2024).

• #83 Multisystem inflammatory syndrome in children (MIS-C) cases by vaccination status in California – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39515133/

  Multisystem inflammatory syndrome in children (MIS-C) is a rare condition occurring after SARS-CoV-2 infection in children under 21 years of age. […] Incidence of MIS-C was compared in unvaccinated and Pfizer-BioNTech vaccinated children aged 12-17 and 5-11 years. […] Compared with vaccinated children, the incident rate ratio of MIS-C was higher among unvaccinated children in both the 12-17-year-old group (22.9, 95 % confidence interval [CI]: 10.5-49.8, p 0.0001) and the 5-11-year-old group (3.3, 95 % CI: 1.6-6.7, p = 0.0004). […] While MIS-C is rare, our results suggest that vaccination with the Pfizer-BioNTech vaccine is protective against MIS-C.

• #84 MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children | RheumNow

  https://rheumnow.com/news/mmwr-vaccination-and-multisystem-inflammatory-syndrome-children

  Overall MIS-C incidence in 2023 was 0.11 cases per million person-months (95% CI = 0.100.14), representing an 80% decline in incidence compared with that during AprilDecember 2022 (0.56 cases per million person-months; 95% CI = 0.510.62), and a 98% decrease from the peak of 6.79 (95% CI = 6.567.03) early in the COVID-19 pandemic (October 2020April 2021). […] MIS-C continues to occur, but at low rates compared with those observed early in the COVID-19 pandemic. […] The reported 2023 incidence is likely an underestimate because jurisdictional reporting of MIS-C cases with illness onset in 2023 is incomplete, and case counts and incidence might also be affected by the change in case definition that occurred that year. […] Clinicians should recognize that MIS-C might occur, especially during and after periods of increased COVID-19 activity, and should be familiar with treatment guidelines. […] COVID-19 vaccination remains an important tool for preventing MIS-C. […] CDC recommends that all children aged 6 months stay up to date with COVID-19 vaccination to protect against serious COVID-19 illness and complications, including MIS-C.

• #85 MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children | RheumNow

  https://rheumnow.com/news/mmwr-vaccination-and-multisystem-inflammatory-syndrome-children

  Overall MIS-C incidence in 2023 was 0.11 cases per million person-months (95% CI = 0.100.14), representing an 80% decline in incidence compared with that during AprilDecember 2022 (0.56 cases per million person-months; 95% CI = 0.510.62), and a 98% decrease from the peak of 6.79 (95% CI = 6.567.03) early in the COVID-19 pandemic (October 2020April 2021). […] MIS-C continues to occur, but at low rates compared with those observed early in the COVID-19 pandemic. […] The reported 2023 incidence is likely an underestimate because jurisdictional reporting of MIS-C cases with illness onset in 2023 is incomplete, and case counts and incidence might also be affected by the change in case definition that occurred that year. […] Clinicians should recognize that MIS-C might occur, especially during and after periods of increased COVID-19 activity, and should be familiar with treatment guidelines. […] COVID-19 vaccination remains an important tool for preventing MIS-C. […] CDC recommends that all children aged 6 months stay up to date with COVID-19 vaccination to protect against serious COVID-19 illness and complications, including MIS-C.

• #86 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  When diagnosing MIS-C, it must be differentiated from other systemic inflammatory disorders and infections that include (Lee Hsueh, 2023; Rabb Kimmel, 2023; Childrens Minnesota, 2024): Kawasaki Disease, Viral infections, Stevens-Johnson Syndrome, Toxic shock syndrome, Systemic juvenile idiopathic arthritis, Bacterial sepsis. […] MIS-C can be very challenging to differentiate from TSS. […] At the present date, there is not any universal protocol for managing MIS-C and treatment for it consists of expert opinion and support of affected organ systems. […] The current recommendation is for all children ages 6 months and older to receive an initial COVID-19 vaccine and at least 1 updated vaccine (CDC, 2024c). […] Parents and children should be educated about the significantly decreased risk of MIS-C for children who are fully up to date on COVID-19 vaccines (Yousaf et al., 2024).

• #87 SciELO Brazil – Multisystem Inflammatory Syndrome in Children (MIS-C) temporally related to COVID-19: the experience at a pediatric reference hospital in Colombia Multisystem Inflammatory Syndrome in Children (MIS-C) temporally related to COVID-19: the e

  https://www.scielo.br/j/rpp/a/FL8MSQtszPK5rbJ5gG8vKTJ/

  The inflammatory, hematological, and coagulation involvement found in our study does not differ from other series. […] This study showed a greater frequency of shock; however, these were critically ill patients exclusively hospitalized in the PICU, unlike our study. […] Severe cases requiring PICU admission and those with cardiac complications seem to be common in this study. […] The underlying causes of MIS-C are still not fully understood. […] The incidence of MIS-C in Latino and Hispanic populations appears to be higher; however, it is not yet clear if there is a greater severity of the disease in low- or middle-income countries, such as some of the Latin American countries. […] In conclusion, the gastrointestinal and mucocutaneous features, blood abnormalities, altered inflammatory and coagulation markers, coronary artery abnormalities, ventricular dysfunction, and intensive care unit admission were frequent, which should highlight the importance of early clinical suspicion.

• #88 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  Early identification of MIS-C is also an important nursing intervention. […] Nurses should be highly suspicious of the disease with children who present with severe abdominal symptoms, hemodynamic instability, cardiac dysfunction, severely elevated inflammatory labs, or shock (Lee Hsueh, 2023). […] An affected child’s condition can deteriorate rapidly, and close monitoring of vital signs, neurologic function, and organ function is necessary so that quick intervention can be initiated should a child experience acute heart failure, cardiac arrest, or shock (Lee Hsueh, 2023). […] It is likely that the implications and long-term consequences of COVID-19 and its complications will continue to evolve over the coming years, and it is important to recognize that the information we have now is still in its infancy. […] MIS-C is one of the most significant new conditions to arise in the pediatric population since the emergence of the novel coronavirus.

• #89 Department of Health | Communicable Disease Service | Multisystem Inflammatory Syndrome (MIS)

  https://www.nj.gov/health/cd/topics/mis.shtml

  Currently, there have been no studies comparing clinical efficacy of various treatment options. […] Treatments have consisted primarily of supportive care and directed care against the underlying inflammatory process and all recommendations are based on the best data and science available at the time.

• #90 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2023.38.e225

  Omicron period were associated with less severe clinical manifestation compared to pre-delta and delta periods. Although incidence rate of MIS-C was lower for the omicron period than pre-delta and delta periods, number of patients reported with MIS-C may pose a substantial clinical burden. […] The main finding of this study was that the incidence of MIS-C during omicron period was lower, while the severity tended to be less severe than that of previous strain-dominant periods. […] Despite these limitations, our data indicate that the omicron variant is associated with less severe MIS-C in Korean children, however, the number of cases can increase due to increased number of SARS-CoV-2 infection.

• #91 Asymptomatic SARS-COV2 Infection or COVID-19 vaccination effect for severe multisystem inflammatory syndrome in a 6-year-old girl: case report and review of the literature | Italian Journal of Pediatrics | Full Text

  https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01758-y

  Cases of vaccine-induced MIS (MIS-V), defined in the absence of prior Sars-Cov2 infection, are exceptional. […] The US national vaccine passive surveillance system reported 79 cases of MIS-C following Covid19 vaccination in the period from 1 January 2020 to 31 December 2022. […] However, it was not possible to establish whether MIS-C was caused by the vaccine or a recent Sars-Cov2 infection or other inflammatory conditions. […] Our case is among the episodic patients aged 12 years old described in the literature and the youngest girl to our knowledge who developed MIS-C after 2 doses of vaccine with a chronology of events that cannot exclude vaccinations involvement in its pathogenesis. […] In conclusion, prompt recognition of MIS-C remains crucial in order to correctly treat the patients even though its incidence has decreased.

• #92 Multisystem inflammatory syndrome in children (MIS-C) and neonates (MIS-N) associated with COVID-19: optimizing definition and management | Pediatric Research

  https://www.nature.com/articles/s41390-022-02263-w

  The phenotype of MIS-C appears to vary with the age of the patient with mucocutaneous and gastrointestinal findings more common in younger children and respiratory presentation more common among adolescents. […] There is considerable overlap between MIS-C and KD with a similar spectrum of disease. […] Given the significant overlap between the 2 entities, and the lack of a definitive diagnostic test for either one, it can be difficult to distinguish between them. […] The diagnostic criteria for MIS during the neonatal period (MIS-N) are controversial and evolving. […] More recently, multisystem inflammation has been described in neonates born to mothers with SARS-CoV-2 infection during pregnancy. […] The use of glucocorticoids and IVIG in neonates with MIS-C is not based on current evidence and warrants further study, in particular given the link between high-dose corticosteroids and neurodevelopmental impairment seen in preterm infants when given to prevent bronchopulmonary dysplasia. […] Further collaborative networks for children with MIS-C or MIS-N to understand the immune function and optimal therapies are vital. […] Multisystem inflammation following COVID-19 is not common but can be associated with high morbidity and mortality.

• #93 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Continued reporting of MIS-C cases to jurisdictional health departments is important to monitor trends and patients demographic and clinical characteristics. […] MIS-C patients with illness onset in 2023 were predominantly unvaccinated children and those whose vaccine-induced immunity had likely waned. […] CDC recommends that all children aged 6 months stay up to date with COVID-19 vaccination to protect against serious COVID-19 illness and complications, including MIS-C.

• #94 Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

  https://ceufast.com/course/multisystem-inflammatory-syndrome-in-children-mis-c-associated-with-covid-19

  While the incidence rate is linked to the rate of COVID-19 cases, the actual occurrence of post-COVID MIS-C is rare. In the early days of the pandemic, the incidence of MIS-C following COVID-19 infection was about 1 in 3,000-4,000 children and teens. […] Five years after the condition first emerged, as of January 2025, there have been 9,750 cases that meet criteria and 80 deaths among children and teens (CDC, 2024b). […] The most significant risk factor, however, is infection with COVID-19, with 98% of cases having a positive test for SARS-CoV-2 and the other 2% testing negative but having a close contact who is positive (CDC, 2024b). […] Current data indicates that about 80% of MIS-C cases are among unvaccinated children and of the 20% who are vaccinated, 60% are not up to date with boosters and their immunity against COVID-19 has waned (Yousaf et al., 2024).

• #95 Multisystem inflammatory syndrome in children (MIS-C) in Canada, CCDR 47(11) – Canada.ca

  https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2021-47/issue-11-november-2021/multisystem-inflammatory-syndrome-children-canada.html

  Nearly all (99%) of MIS-C cases required hospitalization, with 36% requiring intensive care unit admission. […] Cases of MIS-C in Canada are rare; however, when illness does occur it is severe, with nearly all cases requiring hospitalization and one third requiring admission to the intensive care unit. […] The time trend of MIS-C aligns with the time trend of the incidence of COVID-19 in children, with a two- to six-week lag. […] In Canada, MIS-C is more likely to occur in males than females.

• #96 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2023.38.e225

  Omicron period were associated with less severe clinical manifestation compared to pre-delta and delta periods. Although incidence rate of MIS-C was lower for the omicron period than pre-delta and delta periods, number of patients reported with MIS-C may pose a substantial clinical burden. […] The main finding of this study was that the incidence of MIS-C during omicron period was lower, while the severity tended to be less severe than that of previous strain-dominant periods. […] Despite these limitations, our data indicate that the omicron variant is associated with less severe MIS-C in Korean children, however, the number of cases can increase due to increased number of SARS-CoV-2 infection.

• #97 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Continued reporting of MIS-C cases to jurisdictional health departments is important to monitor trends and patients demographic and clinical characteristics. […] MIS-C patients with illness onset in 2023 were predominantly unvaccinated children and those whose vaccine-induced immunity had likely waned. […] CDC recommends that all children aged 6 months stay up to date with COVID-19 vaccination to protect against serious COVID-19 illness and complications, including MIS-C.

• #98 Notes from the Field: Surveillance for Multisystem Inflammatory Syndrome in Children — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7310a2.htm

  Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 26 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. […] MIS-C incidence has decreased from early in the COVID-19 pandemic (highest in late 2020early 2021), but cases continue to occur with a recent relative increase in the fall of 2023 after a period of increased COVID-19 activity in the general population. […] Among 117 patients with MIS-C in 2023, approximately one half required intensive care unitlevel care. […] More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. […] MIS-C cases continue to occur but at low rates, making ongoing surveillance valuable.

• #99 MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children | RheumNow

  https://rheumnow.com/news/mmwr-vaccination-and-multisystem-inflammatory-syndrome-children

  Overall MIS-C incidence in 2023 was 0.11 cases per million person-months (95% CI = 0.100.14), representing an 80% decline in incidence compared with that during AprilDecember 2022 (0.56 cases per million person-months; 95% CI = 0.510.62), and a 98% decrease from the peak of 6.79 (95% CI = 6.567.03) early in the COVID-19 pandemic (October 2020April 2021). […] MIS-C continues to occur, but at low rates compared with those observed early in the COVID-19 pandemic. […] The reported 2023 incidence is likely an underestimate because jurisdictional reporting of MIS-C cases with illness onset in 2023 is incomplete, and case counts and incidence might also be affected by the change in case definition that occurred that year. […] Clinicians should recognize that MIS-C might occur, especially during and after periods of increased COVID-19 activity, and should be familiar with treatment guidelines. […] COVID-19 vaccination remains an important tool for preventing MIS-C. […] CDC recommends that all children aged 6 months stay up to date with COVID-19 vaccination to protect against serious COVID-19 illness and complications, including MIS-C.

• #100 MIS-C Data and Reporting

  https://www.michigan.gov/coronavirus/stats/mis-c-reporting

  Publishing MIS-C surveillance has provided awareness of the condition and severe COVID outcomes for the public and providers. […] Multisystem Inflammatory Syndrome in Children (MIS-C) is a delayed hyperinflammatory condition in children and adolescents that occurs 2-6 weeks after SARS-CoV-2 infection. […] Health care providers and local health departments are asked to maintain a high degree of suspicion for MIS-C in pediatric and adolescent patients presenting with symptoms similar to Kawasaki Disease or ill individuals who have been previously exposed to COVID-19 with signs and symptoms. […] Patients have presented with fever, shock, multiorgan (cardiac, gastrointestinal, hematologic and dermatologic) involvement, and elevated inflammatory markers. […] Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) […] Current (2023) Definition: https://www.cdc.gov/mis/mis-c/hcp_cstecdc/index.html.

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