Role of the new coronavirus infection caused by the SARS-COV-2 virus in the manifestation of multisystem inflammatory syndrome

Khidirova L.D.; Fedoruk V.A.; Vasiliev K.O.

doi:https://doi.org/10.17116/profmed202124061110

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Abstract:

In a series of clinical cases, a picture of an acute condition is described based on a new coronavirus infection COVID-19 that is accompanied by a pronounced inflammatory reaction of the vessels followed by the development of multiple organ failure syndrome. Therefore, a detailed study of the problem of multisystem inflammatory disorder is required taking into account the peculiarities of the pathogenesis and clinical picture, as well as differential analysis with Kawasaki syndrome, toxic shock syndrome and hemophagocytic lymphohistiocytosis based on concomitant rheumatic disease. In this regard, it is necessary to establish the data collection in a standardized form as early as possible with a description of the clinical picture of the specified condition, the severity of the course, outcomes and epidemiological characteristics. The World Health Organization has already prepared preliminary definitions and notification form for cases of multisystem inflammatory disorder. Our active participation will allow identifying new cases of multisystem inflammatory syndrome and thereby contributing to rational treatment and epidemiological surveillance.

Keywords:

SARS-CoV-2 coronavirus

multisystem inflammatory syndrome

Kawasaki syndrome

vasculitis

Authors:

Khidirova L.D.

Novosibirsk State Medical University

SPIN RSCI: 7932-6544
Scopus AuthorID: 57195757496
ORCID: 0000-0002-1250-8798

Fedoruk V.A.

Novosibirsk State Medical University

Vasiliev K.O.

Novosibirsk State Medical University

Received:

22.01.2021

Accepted:

09.03.2021

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References:

Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, Quaderi S, Mandal S, Hurst JR. Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. PLoS One. 2020;15(5):e0233147. https://doi.org/10.1371/journal.pone.0233147
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi.org/10.1056/nejmoa2021756
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229): 1054-1062. https://doi.org/10.1016/S1473-3099(20)30651-4
Jiehao C, Jin X, Daojiong L, Zhi Y, Lei X, Zhenghai Q, Yuehua Z, Hua Z, Ran J, Pengcheng L, Xiangshi W, Yanling G, Aimei X, He T, Hailing C, Chuning W, Jingjing L, Jianshe W, Mei Z. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547-1551. https://doi.org/10.1093/cid/ciaa198
Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169-1174. https://doi.org/10.1002/ppul.24718
Wei M, Yuan J, Liu Y, Fu T, Yu X, Zhang ZJ. Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China. JAMA. 2020;323(13): 1313-1314. https://doi.org/10.1001/jama.2020.2131
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S, Li Y, Wu C, Liu H, Liu D, Shao J, Peng X, Yang Y, Liu Z, Xiang Y, Zhang F, Silva RM, Pinkerton KE, Shen K, Xiao H, Xu S, Wong GWK; Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663-1165. https://doi.org/10.1056/NEJMc2005073
Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, De Leacy RA, Shigematsu T, Ladner TR, Yaeger KA, Skliut M, Weinberger J, Dangayach NS, Bederson JB, Tuhrim S, Fifi JT. Large-vessel stroke as a presenting feature of Covid-19 in the young. N Engl J Med. 2020;382:e60. https://doi.org/10.1056/NEJMc2009787
Magro C, Mulvey JJ, Berlin D, Nuovo G, Salvatore S, Harp J, Baxter-Stoltzfus A, Laurence J. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res. 2020;220:1-13. https://doi.org/10.1016/j.trsl.2020.04.007
Royal College of Paediatrics and Child Health. Guidance: Paediatric multisystem inflammatory syndrome temporally associated with COVID. Accessed May 15, 2020. https://www.rcpch.ac.uk/sites/default/files/2020-05/COVID-19-Paediatric-multisystem-%20inflammatory%20syndrome-20200501.pdf
Kamali Aghdam M, Jafari N, Eftekhari K. Novel coronavirus in a 15-day-old neonate with clinical signs of sepsis, a case report. Infect Dis (Lond). 2020;52(6):427-429. https://doi.org/10.1080/23744235.2020.1747634
Team CC-R. Coronavirus Disease 2019 in Children — United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(14): 422-426. https://doi.org/10.15585/mmwr.mm6914e4
Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395(10237):1607-1608. https://doi.org/10.1016/S0140-6736(20)31094-1
DeBiasi RL, Song X, Delaney M, Bell M, Smith K, Pershad J, Ansusinha E, Hahn A, Hamdy R, Harik N, Hanisch B, Jantausch B, Koay A, Steinhorn R, Newman K, Wessel D. Severe COVID-19 in Children and Young Adults in the Washington, DC Metropolitan Region. J Pediatr. 2020 223:199-203.e1. https://doi.org/10.1016/j.jpeds.2020.05.007
Jones VG, Mills M, Suarez D, Hogan CA, Yeh D, Segal JB, Nguyen EL, Barsh GR, Maskatia S, Mathew R. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr. 2020;10(6):537-540. https://doi.org/10.1542/hpeds.2020-0123
Centers for Disease Control and Prevention Health Alert Network (HAN). Multisystem Inflammatory Syndrome in Children (MIS-C). Associated with Coronavirus Disease 2019 (COVID-19); 2020. Accessed May 15, 2020. https://emergency.cdc.gov/han/2020/han00432.asp
World Health Organization. Multisystem inflammatory syndrome in children and adolescents with COVID-19. Scientific Brief. Geneva: WHO; 2020. Accessed May 17, 2020. https://www.who.int/publications-detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19
Jones VG, Mills M, Suarez D, Hogan CA, Yeh D, Bradley Segal J, et al. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr. 2020. Epub 2020/04/09 https://doi.org/10.1542/hpeds.2020-0123
Riphagen S, Gomez X, Gonzales-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395(10237):1607-1608. https://doi.org/10.1016/S0140-6736(20)31094-1
World Health Organization. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. Geneva: WHO; 2020. Accessed February 12, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020. Geneva: WHO; 2020. Accessed May 01, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE, Shah P, Ramnarayan P, Fraisse A, Miller O, Davies P, Kucera F, Brierley J, McDougall M, Carter M, Tremoulet A, Shimizu C, Herberg J, Burns JC, Lyall H, Levin M; PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical characteristics of 58 children with pediatric inflammatory Multisystem syndrome temporarily associated with SARS-CoV-2. JAMA. 2020;324:259.
Cheung EW, Zachariah P, Gorelik M, Boneparth A, Kernie SG, Orange JS, Milner JD. Multisystem inflammatory syndrome associated with COVID-19 in previously healthy children and adolescents in New York city. JAMA. 2020;324(3):294-296. https://doi.org/10.1001/jama.2020.10374
Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, Newburger JW, Kleinman LC, Heidemann SM, Martin AA, Singh AR, Li S, Tarquinio KM, Jaggi P, Oster ME, Zackai SP, Gillen J, Ratner AJ, Walsh RF, Fitzgerald JC, Keenaghan MA, Alharash H, Doymaz S, Clouser KN, Giuliano JS Jr, Gupta A, Parker RM, Maddux AB, Havalad V, Ramsingh S, Bukulmez H, Bradford TT, Smith LS, Tenforde MW, Carroll CL, Riggs BJ, Gertz SJ, Daube A, Lansell A, Coronado Munoz A, Hobbs CV, Marohn KL, Halasa NB, Patel MM, Randolph AG; Overcoming COVID-19 Investigators; CDC COVID-19 Response Team. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020;383(4):334-346. https://doi.org/10.1056/NEJMoa2021680
Centers for Disease Control and Prevention. 2019 Novel coronavirus, Wuhan, China. Information for Healthcare Professionals. Accessed February 14, 2020. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html
Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, Bonanomi E, D’Antiga L. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395(10239):1771-1778. https://doi.org/10.1016/S0140-6736(20)31103-X
World Health Organization. Novel Coronavirus (2019-nCoV) technical guidance. Geneva: WHO; 2020. Accessed on February 14, 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance
Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, Barranco MA, Maxted AM, Rosenberg ES, Easton D, Udo T, Kumar J, Pulver W, Smith L, Hutton B, Blog D, Zucker H; New York State and Centers for Disease Control and Prevention Multisystem Inflammatory Syndrome in Children Investigation Team. Multisystem Inflammatory Syndrome in Children in New York State. N Engl J Med. 2020;383(4):347-358. https://doi.org/10.1056/NEJMoa2021756
Pang J, Boshier FAT, Alders N, Dixon G, Breuer J. SARS-CoV-2 Polymorphisms and Multisystem Inflammatory Syndrome in Children. Pediatrics. 2020;146(6):e2020019844. https://doi.org/10.1542/peds.2020-019844
Sperotto F, Friedman KG, Son MBF, VanderPluym CJ, Newburger JW, Dionne A. Cardiac manifestations in SARS-CoV-2-associated multisystem inflammatory syndrome in children: a comprehensive review and proposed clinical approach. Eur J Pediatr. 2021;180(2):307-322. https://doi.org/10.1007/s00431-020-03766-6
Dolhnikoff M, Ferreira Ferranti J, de Almeida Monteiro RA, Duarte-Neto AN, Soares Gomes-Gouvêa M, Viu Degaspare N, Figueiredo Delgado A, Montanari Fiorita C, Nunes Leal G, Rodrigues RM, Taverna Chaim K, Rebello Pinho JR, Carneiro-Sampaio M, Mauad T, Ferraz da Silva LF, Brunow de Carvalho W, Saldiva PHN, Garcia Caldini E. SARS-CoV-2 in cardiac tissue of a child with COVID-19-related multisystem inflammatory syndrome. Lancet Child Adolesc Health. 2020;4(10):790-794. https://doi.org/10.1016/S2352-4642(20)30257-1
Kaushik A, Gupta S, Sood M, Sharma S, Verma S. A Systematic Review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection. Pediatr Infect Dis J. 2020;39(11):340-346. https://doi.org/10.1097/INF.0000000000002888
Radia T, Williams N, Agrawal P, Harman K, Weale J, Cook J, Gupta A.. Multi-system inflammatory syndrome in children & adolescents (MIS-C): A systematic review of clinical features and presentation. Paediatr Respir Rev. 2020:S1526-0542(20)30117-2. https://doi.org/10.1016/j.prrv.2020.08.001
Halyabar O, Chang MH, Schoettler ML, Schwartz MA, Baris EH, Benson LA, Biggs CM, Gorman M, Lehmann L, Lo MS, Nigrovic PA, Platt CD, Priebe GP, Rowe J, Sundel RP, Surana NK, Weinacht KG, Mann A, Yuen JC, Meleedy-Rey P, Starmer A, Banerjee T, Dedeoglu F, Degar BA, Hazen MM, Henderson LA. Calm in the midst of cytokine storm: A collaborative approach to the diagnosis and treatment of hemophagocytic lymphohistiocytosis and macrophage activation syndrome. Pediatr Rheumatol Online J. 2019;17(1):7. https://doi.org/10.1186/s12969-019-0309-6
Tullie L, Ford K, Bisharat M, Watson T, Thakkar H, Mullassery D, Giuliani S, Blackburn S, Cross K, De Coppi P, Curry J. Gastrointestinal features in children with COVID-19: an observation of varied presentation in eight children. Lancet Child Adolesc Health. 2020;4(7):19-20. https://doi.org/10.1016/S2352-4642(20)30165-6
Abdel-Mannan O, Eyre M, Löbel U, Bamford A, Eltze C, Hameed B, Hemingway C, Hacohen Y. Neurologic and Radiographic Findings Associated With COVID-19 Infection in Children. JAMA Neurol. 2020;77(11):1-6. https://doi.org/10.1001/jamaneurol.2020.2687
Hanson KE, Caliendo AM, Arias CA, Englund JA, Hayden MK, Lee MJ, Loeb M, Patel R, Altayar O, El Alayli A, Sultan S, Falck-Ytter Y, Lavergne V, Morgan RL, Murad MH, Bhimraj A, Mustafa RA. Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19: Serologic Testing. Clin Infect Dis. 2020:ciaa1343. https://doi.org/10.1093/cid/ciaa1343
Henderson LA, Canna SW, Schulert GS, Volpi S, Lee PY, Kernan KF, Caricchio R, Mahmud S, Hazen MM, Halyabar O, Hoyt KJ, Han J, Grom AA, Gattorno M, Ravelli A, De Benedetti F, Behrens EM, Cron RQ, Nigrovic PA. On the alert for cytokine storm: Immunopathology in COVID-19. Arthritis Rheumatol. 2020;72(7):1059-1063. https://doi.org/10.1002/art.41285
Halyabar O, Chang MH, Schoettler ML, Schwartz MA, Baris EH, Benson LA, Biggs CM, Gorman M, Lehmann L, Lo MS, Nigrovic PA, Platt CD, Priebe GP, Rowe J, Sundel RP, Surana NK, Weinacht KG, Mann A, Yuen JC, Meleedy-Rey P, Starmer A, Banerjee T, Dedeoglu F, Degar BA, Hazen MM, Henderson LA. Calm in the midst of cytokine storm: a collaborative approach to the diagnosis and treatment of hemophagocytic lymphohistiocytosis and mac- rophage activation syndrome. Pediatr Rheumatol Online J. 2019;17(1):7. https://doi.org/10.1186/s12969-019-0309-6
Henderson LA, Cron RQ. Macrophage Activation Syndrome and Secondary Hemophagocytic Lymphohistiocytosis in Childhood Inflammatory Disorders: Diagnosis and Management. Paediatr Drugs. 2020;22(1):29-44. https://doi.org/10.1007/s40272-019-00367-1
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