COVID-19 Clinical Resources and Pertinent Research
A daily updated list of the most useful COVID-19 clinical resources and the most significant research publications with a summary of their key findings. To contribute, click the plus button on the left. Short URL: bit.ly/C19Res
Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19
CDC Case Definition
Patients <21 years presenting with fever of >38.0°C for ≥24 hours or subjective fever ≥24 hours; AND
Laboratory evidence of inflammation including, but not limited to, one or more of the following: an elevated CRP, ESR, fibrinogen, procalcitonin, d-dimer, ferritin, LDH, or IL-6, elevated neutrophils, reduced lymphocytes, and low albumin; AND
Evidence of clinically severe illness requiring hospitalization with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); AND
No alternative plausible diagnoses; AND
Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms
Consider MIS-C in any pediatric death with evidence of SARS-CoV-2 infection.
5/14 – CDC Alert: Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19 The Centers for Disease Control and Prevention (CDC) is providing 1) background information on several cases of a recently reported multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19); and 2) a case definition for this syndrome. CDC recommends healthcare providers report any patient who meets the case definition to local, state, and territorial health departments to enhance knowledge of risk factors, pathogenesis, clinical course, and treatment of this syndrome.
5/4 – NYC Health Department Health Alert on Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19 Fifteen cases compatible with multi-system inflammatory syndrome have been identified in children in New York City hospitals. Characterized by persistent fever and features of Kawasaki disease and/or toxic shock syndrome; abdominal symptoms common. Cases may require intensive care unit admission for cardiac and/or respiratory support. Polymerase chain reaction testing for SARS-CoV-2 may be positive or negative. Notably, 6 patients with negative testing by PCR were positive by serology. Early recognition and specialist referral are essential, including to critical care if warranted. Immediately report cases to the New York City Health Department.
4/27 – PICSUK Statement on Increased Novel Presentation of Multi-system Inflammatory Disease in COVID-19 NHS England has highlighted a small rise in the number of cases of critically ill children presenting with features of toxic shock
syndrome and atypical Kawasaki disease with blood parameters consistent with severe COVID-19 (elevated CRP, ESR, and ferritin). Additionally, abdominal pain and gastrointestinal symptoms have been a common feature as has myocarditis with raised troponin and proBNP. Some patients have an coronary arteries with appearance consistent with Kawasaki Disease.