TY - JOUR
T1 - In-hospital unfavorable outcomes of MIS-C during 2020–2022
T2 - a systematic review
AU - Alvarado-Gamarra, Giancarlo
AU - Alcalá-Marcos, Katherine
AU - Balmaceda-Nieto, Pía
AU - Visconti-Lopez, Fabriccio J.
AU - Torres-Balarezo, Pedro
AU - Morán-Mariños, Cristian
AU - Velásquez-Rimachi, Victor
AU - Chavez-Malpartida, Sandra S.
AU - Alva-Díaz, Carlos
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
PY - 2024
Y1 - 2024
N2 - Studies on the severity in multisystem inflammatory syndrome in children (MIS-C) show heterogeneous results and may not reflect a global perspective. This systematic review aims to estimate the frequency of in-hospital unfavorable outcomes in patients with MIS-C over the 3 years since the onset of the SARS-CoV-2 pandemic. A systematic search was conducted in Medline, Scopus, Embase, Cochrane, Web of Science, Scielo, and preprint repositories until December 15, 2022. Study selection and data extraction were evaluated independently. The primary outcomes were intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and death. Additionally, we evaluated cardiovascular-related outcomes. We performed a random-effects model meta-analysis and assessed the certainty of the evidence. Fifty-seven studies (n = 13 254) were included. The frequency of ICU admission was 44.7% (95% CI 38.8–50.7), 11.9% for IMV (95% CI 9.6–14.4), and 2.0% for death (95% CI 1.3–3.0). The requirement of vasoactive/inotropic drugs was 40.1% (95% CI 35.9–44.4), 7.9% for coronary aneurysm (95% CI 4.1–12.7), 30.7% for decreased left ventricle ejection fraction (LVEF) (95% CI 26.3–35.4), and 29.7% for myocarditis (95% CI 18.4–42.4). We assess the included evidence as being of very low certainty. Finally, excess COVID-19 mortality by country and the diagnostic criteria for MIS-C (CDC compared to WHO) were associated with a higher frequency of ICU admissions. The year of study conduction (2022 compared to 2020) was associated with a lower frequency of IMV. Conclusion: The frequency of in-hospital unfavorable outcomes in patients with MIS-C was high. Well-designed studies are needed to explore other heterogeneity sources. Protocol registration: CRD42021284878. (Table presented.).
AB - Studies on the severity in multisystem inflammatory syndrome in children (MIS-C) show heterogeneous results and may not reflect a global perspective. This systematic review aims to estimate the frequency of in-hospital unfavorable outcomes in patients with MIS-C over the 3 years since the onset of the SARS-CoV-2 pandemic. A systematic search was conducted in Medline, Scopus, Embase, Cochrane, Web of Science, Scielo, and preprint repositories until December 15, 2022. Study selection and data extraction were evaluated independently. The primary outcomes were intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and death. Additionally, we evaluated cardiovascular-related outcomes. We performed a random-effects model meta-analysis and assessed the certainty of the evidence. Fifty-seven studies (n = 13 254) were included. The frequency of ICU admission was 44.7% (95% CI 38.8–50.7), 11.9% for IMV (95% CI 9.6–14.4), and 2.0% for death (95% CI 1.3–3.0). The requirement of vasoactive/inotropic drugs was 40.1% (95% CI 35.9–44.4), 7.9% for coronary aneurysm (95% CI 4.1–12.7), 30.7% for decreased left ventricle ejection fraction (LVEF) (95% CI 26.3–35.4), and 29.7% for myocarditis (95% CI 18.4–42.4). We assess the included evidence as being of very low certainty. Finally, excess COVID-19 mortality by country and the diagnostic criteria for MIS-C (CDC compared to WHO) were associated with a higher frequency of ICU admissions. The year of study conduction (2022 compared to 2020) was associated with a lower frequency of IMV. Conclusion: The frequency of in-hospital unfavorable outcomes in patients with MIS-C was high. Well-designed studies are needed to explore other heterogeneity sources. Protocol registration: CRD42021284878. (Table presented.).
KW - COVID-19
KW - Critical care outcomes
KW - Fatal outcome
KW - Pediatric multisystem inflammatory disease, COVID-19 related
KW - Pediatrics (Source: MeSH terms)
UR - http://www.scopus.com/inward/record.url?scp=85205339110&partnerID=8YFLogxK
U2 - 10.1007/s00431-024-05787-x
DO - 10.1007/s00431-024-05787-x
M3 - Artículo de revisión
AN - SCOPUS:85205339110
SN - 0340-6199
JO - European Journal of Pediatrics
JF - European Journal of Pediatrics
ER -