SynthesisBMJ paediatrics open2024
Clinical presentation, diagnosis and management of multisystem inflammatory syndrome in children (MIS-C): a systematic review.
Synthesis in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- MIS-C: Diagnosis, Management, and Outcomes.Open forum infectious diseases · 2026Review
- "Characteristics of children with multisystem inflammatory syndrome in children during different COVID-19 waves "Single centre Study".BMC pediatrics · 2025Observational
- Comparison of Immunomodulatory Therapies for Cardiovascular Clinical and Inflammatory Markers Outcomes in Mild to Moderately Ill Hospitalized Multisystem Inflammatory Syndrome in Children Patients.Journal of cardiovascular development and disease · 2025Article
- Multisystem inflammatory syndrome in children and Kawasaki disease.Frontiers in immunology · 2025Review
- Multisystem Inflammatory Syndrome in Children (MIS-C) in a Lithuanian Paediatric Tertiary Care Center.Medicina (Kaunas, Lithuania) · 2024Observational
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKnowledge about multisystem inflammatory syndrome in children (MIS-C) is evolving, and evidence-based standardised diagnostic and management protocols are lacking. Our review aims to summarise the clinical and diagnostic features, management strategies and outcomes of MIS-C and evaluate the variances in disease parameters and outcomes between high-income countries (HIC) and middle-income countries (MIC).
methodsWe searched four databases from December 2019 to March 2023. Observational studies with a sample size of 10 or more patients were included. Mean and prevalence ratios for various variables were pooled by random effects model using R. A mixed generalised linear model was employed to account for the heterogeneity, and publication bias was assessed via funnel and Doi plots. The primary outcome was pooled mean mortality among patients with MIS-C. Subgroup analysis was conducted based on the income status of the country of study.
resultsA total of 120 studies (20 881 cases) were included in the review. The most common clinical presentations were fever (99%; 95% CI 99.6% to 100%), gastrointestinal symptoms (76.7%; 95% CI 73.1% to 79.9%) and dermatological symptoms (63.3%; 95% CI 58.7% to 67.7%). Laboratory investigations suggested raised inflammatory, coagulation and cardiac markers. The most common management strategies were intravenous immunoglobulins (87.5%; 95% CI 82.9% to 91%) and steroids (74.7%; 95% CI 68.7% to 79.9%). Around 53.1% (95% CI 47.3% to 58.9%) required paediatric intensive care unit admissions, and overall mortality was 3.9% (95% CI 2.7% to 5.6%). Patients in MIC were younger, had a higher frequency of respiratory distress and evidence of cardiac dysfunction, with a longer hospital and intensive care unit stay and had a higher mortality rate than patients in HIC.
conclusionMIS-C is a severe multisystem disease with better mortality outcomes in HIC as compared with MIC. The findings emphasise the need for standardised protocols and further research to optimise patient care and address disparities between HIC and MIC. PROSPERO REGISTRATION NUMBER: CRD42020195823.
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