Multisystem Inflammatory Syndrome in Children (MIS-C), a Post-viral Myocarditis and Systemic Vasculitis-A Critical Review of Its Pathogenesis and Treatment

Jeremy C McMurray, Joseph W May, Madeleine W Cunningham, Olcay Y Jones, Jeremy C McMurray, Joseph W May, Madeleine W Cunningham, Olcay Y Jones

Abstract

MIS-C is a newly defined post-viral myocarditis and inflammatory vasculopathy of children following COVID-19 infection. This review summarizes the literature on diagnosis, parameters of disease severity, and current treatment regimens. The clinical perspective was analyzed in light of potential immunopathogenesis and compared to other post-infectious and inflammatory illnesses of children affecting the heart. In this paradigm, the evidence supports the importance of endothelial injury and activation of the IL-1 pathway as a common determinant among MIS-C, Kawasaki disease, and Acute Rheumatic fever.

Keywords: IL-1 (interleukin-1); MIS-C; coronary artery aneurysm; myocarditis; vasculitis.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2020 McMurray, May, Cunningham and Jones.

Figures

Figure 1
Figure 1
Initial recognition and management of MIS-C.
Figure 2
Figure 2
Management of patients presenting with MIS-C.
Figure 3
Figure 3
Management algorithm based on the patient's clinical status and response to initial treatment.

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