Evidence map›Paper›PMID 38844384›Full record

SynthesisBMJ paediatrics open2024

Clinical presentation, diagnosis and management of multisystem inflammatory syndrome in children (MIS-C): a systematic review.

Qalab Abbas, Haider Ali, Fatima Amjad, Muhammad Zaid Hamid Hussain, Abdu R Rahman, Maryam Hameed Khan, Zahra A Padhani, Fatima Abbas, Danyal Imam, Zuviya Alikhan and 6 more

Abstract readSystematic Review
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. MIS-C: Diagnosis, Management, and Outcomes.Open forum infectious diseases · 2026
    Review
  2. Observational
  3. Article
  4. Review
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Qalab Abbas *Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan qalab.abbas@aku.edu.
Haider Ali *Department of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.ORCID http://orcid.org/0000-0001-7845-6065
Fatima AmjadDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Muhammad Zaid Hamid HussainDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Abdu R RahmanDepartment of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan.
Maryam Hameed KhanInstitute for Global Health and Development, The Aga Khan University, Karachi, Sind, Pakistan.
Zahra A PadhaniSchool of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Fatima AbbasDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Danyal ImamDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Zuviya AlikhanDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Sameer M BelgaumiDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Shazia MohsinDepartment of Pediatric cardiology, Division of cardiothoracic sciences, Sindh institute of Urology and Transplantation (SIUT), Karachi, Sind, Pakistan.
Faiza SattarDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Arsalan SiddiquiDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.
Zohra S LassiSchool of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Jai K DasDepartment of Pediatrics and Child Health, The Aga Khan University, Karachi, Sind, Pakistan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Systemic Inflammatory Response SyndromeChildCOVID-19HumansCOVID-19mortality

Identifiers

PMID38844384
PMCPMC11163633

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.