Paediatric Multisystem Inflammatory Syndrome Associated with COVID-19: Advances, Controversies, and Future Perspectives
Juan Pablo Martínez-Becerra
Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health from Guanajuato State, Guanajuato, México.
Miztli David Aguilar-Caballero
Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health from Guanajuato State, Guanajuato, México.
Ma Guadalupe León-Verdín
Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health from Guanajuato State, Guanajuato, México.
María de Jesús Gallardo-Luna
Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health from Guanajuato State, Guanajuato, México.
Efraín Navarro-Olivos
Directorate of Teaching and Research, Institute of Public Health from Guanajuato State, Guanajuato, México.
Leticia Zamora-Ramos
General Directorate of Medical Care, Institute of Public Health from Guanajuato State, México.
Nicolás Padilla-Raygoza *
Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health from Guanajuato State, Guanajuato, México.
*Author to whom correspondence should be addressed.
Abstract
Paediatric multisystem inflammatory syndrome (MIS-C), temporally linked to SARS-CoV-2 infection, emerged in 2020 as a condition of significant clinical concern due to its potential to cause multiorgan dysfunction and severe outcomes. It is a post-infectious phenomenon characterised by a dysregulated immune response and intense systemic inflammation. This review analyses scientific findings from the past decade, with emphasis on advances in pathophysiology, updated diagnostic criteria, epidemiological changes over the course of the pandemic, diversity of clinical manifestations, therapeutic strategies, and future perspectives. In 2020, the first cases of MIS-C were diagnosed as Kawasaki disease, and after changes, like Kawasaki disease. The documented experience of a second-level hospital in Guanajuato, Mexico, is also incorporated, allowing reflection on diagnostic and therapeutic challenges in middle-resource settings. Although incidence has decreased following the circulation of recent variants and the implementation of vaccination, MIS-C continues to represent a challenge for global paediatrics.
Keywords: Paediatric multisystem inflammatory syndrome, SARS-CoV-2, COVID-19, paediatric inflammation, Kawasaki-like syndrome, Post-infectious complications, immunomodulation, epidemiology