Pediatric Systemic Inflammatory Syndrome Associated with SARS-CoV-2

Abstract

SARS-CoV-2 infection is rare in children and adolescents, with mild or asymptom- atic clinical manifestations, but since April 2020, seriously ill children have been reported in areas with the highest incidence of coronavirus infections, character- ized by fever, gastrointestinal symptoms and markers of systemic inflammation, significant cardiovascular compromise (shock, myocardial dysfunction or myocar- ditis), with similarities to Kawasaki disease, cytokine storm and macrophage acti- vation syndrome, called Pediatric Multisystemic Inflammatory Syndrome (PIMS / MIS-C) ). The pathogenesis is not exactly known, but an altered innate and adap- tive immune response associated with autoimmunity could be the mechanism. Although there is no standardized therapeutic guide, most patients receive intra- venous gamma globulin and systemic corticosteroids, and in some cases the use of interleukin inhibitors is required. A good response and improvement has been reported in almost all children, with a low fatality rate of 1.7-2%.