Post-COVID-19 multisystem inflammatory syndrome: An evolving concept
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Scientia Medica (Porto Alegre. Online) |
Texto Completo: | https://revistaseletronicas.pucrs.br/scientiamedica/article/view/42436 |
Resumo: | INTRODUCTION: A potential association of COVID-19 with inflammatory and autoimmune phenomena opens a new chapter in clinical practice. Among several inflammatory conditions described in the post-COVID-19 context, Kawasaki disease and a new condition named multisystem inflammatory syndrome stand out.AIMS: To review, in a practical and concise way, the concept and diagnostic criteria of multisystem inflammatory syndrome, the overlaps with Kawasaki disease, as well as the immunopathogenesis and treatment of this new and intriguing condition.METHODS: Literature review available in the Pubmed database, with emphasis on systematic reviews with meta-analyses.RESULTS: The multisystem inflammatory syndrome is a post-viral, multiorgan hyperinflammatory disorder. The condition is primarily pediatric, and the first cases were reported in England in May 2020. Diagnostic criteria are still imprecise, and include some Kawasaki disease-like manifestations. However, multisystem inflammatory syndrome differs from Kawasaki disease by usually affecting children above five years of age and of black or hispanic races; in clinical terms, it is distinguished by the high frequency of gastroenteropathy, cardiomyopathy and shock. Differential diagnosis includes bacterial sepsis, macrophage activation syndrome, and systemic forms of rheumatoid arthritis. An overexpression of interferons and other inflammatory cytokines pathogenically characterize the multisystem inflammatory syndrome. The disease is, as a rule, responsive to intensive care, steroids, intravenous immunoglobulin, and immunobiologics.CONCLUSIONS: Multisystem inflammatory syndrome is a new and complex hyperinflammatory condition associated with previous exposure to SARS-CoV-2. It shows interesting interfaces with Kawasaki disease. Despite the recent description, the literature is already quantitatively robust, and some pending issues in immunopathogenesis, diagnostic criteria and therapy should be shortly clarified. |
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Post-COVID-19 multisystem inflammatory syndrome: An evolving conceptSíndrome inflamatória multissistêmica (SIMS) pós-COVID-19: Um conceito em evoluçãomultisystem inflammatory syndromeKawasaki diseaseSARS-CoV-2COVID-19síndrome inflamatória multissistêmicadoença de KawasakiSARS-CoV-2COVID-19INTRODUCTION: A potential association of COVID-19 with inflammatory and autoimmune phenomena opens a new chapter in clinical practice. Among several inflammatory conditions described in the post-COVID-19 context, Kawasaki disease and a new condition named multisystem inflammatory syndrome stand out.AIMS: To review, in a practical and concise way, the concept and diagnostic criteria of multisystem inflammatory syndrome, the overlaps with Kawasaki disease, as well as the immunopathogenesis and treatment of this new and intriguing condition.METHODS: Literature review available in the Pubmed database, with emphasis on systematic reviews with meta-analyses.RESULTS: The multisystem inflammatory syndrome is a post-viral, multiorgan hyperinflammatory disorder. The condition is primarily pediatric, and the first cases were reported in England in May 2020. Diagnostic criteria are still imprecise, and include some Kawasaki disease-like manifestations. However, multisystem inflammatory syndrome differs from Kawasaki disease by usually affecting children above five years of age and of black or hispanic races; in clinical terms, it is distinguished by the high frequency of gastroenteropathy, cardiomyopathy and shock. Differential diagnosis includes bacterial sepsis, macrophage activation syndrome, and systemic forms of rheumatoid arthritis. An overexpression of interferons and other inflammatory cytokines pathogenically characterize the multisystem inflammatory syndrome. The disease is, as a rule, responsive to intensive care, steroids, intravenous immunoglobulin, and immunobiologics.CONCLUSIONS: Multisystem inflammatory syndrome is a new and complex hyperinflammatory condition associated with previous exposure to SARS-CoV-2. It shows interesting interfaces with Kawasaki disease. Despite the recent description, the literature is already quantitatively robust, and some pending issues in immunopathogenesis, diagnostic criteria and therapy should be shortly clarified.INTRODUÇÃO: A potencial associação da COVID-19 com fenômenos inflamatórios e autoimunes abre um novo capítulo na prática clínica. Entre várias condições inflamatórias descritas no pós-COVID-19, destacam-se a doença de Kawasaki e uma nova afecção denominada síndrome inflamatória multissistêmica.OBJETIVOS: Revisar, de forma prática e concisa, conceito e critérios diagnósticos da síndrome inflamatória multisistêmica, as sobreposições com a doença de Kawasaki, assim como a imunopatogênese e o tratamento desta nova e intrigante enfermidade.MÉTODOS: Revisão da literatura disponível na base de dados Pubmed, com ênfase em revisões sistemáticas com metaanálises.RESULTADOS: A síndrome inflamatória multisistêmica se configura como uma condição hiperinflamatória multiorgânica pós-viral. A condição é primordialmente pediátrica, e os primeiros casos foram descritos na Inglaterra em maio de 2020. Os critérios diagnósticos são ainda imprecisos, e incluem algumas manifestações doença de Kawasaki-símiles. A síndrome inflamatória multisistêmica difere da doença de Kawasaki, entretanto, por geralmente acometer crianças acima cinco anos e de raças negras ou hispânicas; em termos clínicos, se distingue pela alta frequência de gastroenteropatia, miocardiopatia e choque. O diagnóstico diferencial inclui sepse bacteriana, síndrome de ativação macrofágica e formas sistêmicas de artrite reumatoide. Uma hiperexpressão de interferons e de outras citocinas inflamatórias caracteriza patogenicamente a síndrome inflamatória mulsistêmica. A enfermidade é, via de regra, responsiva a cuidados de terapia intensiva, corticóides, imunoglobulina intravenosa e imunobiológicos.CONCLUSÕES: A síndrome inflamatória multisistêmica é uma nova e complexa afecção hiperinflamatória associada à exposição prévia ao SARS-CoV-2. Apresenta instigantes interfaces com a doença de Kawasaki. Apesar da descrição recente, a literatura já é quantitativamente robusta, e algumas pendências de imunopatogênese, critérios diagnósticos e terapêutica deverão ser esclarecidas em breve.Editora da PUCRS - ediPUCRS2022-01-25info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/4243610.15448/1980-6108.2022.1.42436Scientia Medica; Vol. 32 No. 1 (2022): Single Volume; e42436Scientia Medica; v. 32 n. 1 (2022): Volume Único; e424361980-61081806-556210.15448/1980-6108.2022.1reponame:Scientia Medica (Porto Alegre. Online)instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSporhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/42436/27369Copyright (c) 2022 Scientia Medicahttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessStaub, Henrique LuizStaub, Lia Portella2022-12-16T12:09:43Zoai:ojs.revistaseletronicas.pucrs.br:article/42436Revistahttps://revistaseletronicas.pucrs.br/scientiamedica/PUBhttps://revistaseletronicas.pucrs.br/scientiamedica/oaiscientiamedica@pucrs.br || editora.periodicos@pucrs.br1980-61081806-5562opendoar:2022-12-16T12:09:43Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.none.fl_str_mv |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept Síndrome inflamatória multissistêmica (SIMS) pós-COVID-19: Um conceito em evolução |
title |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept |
spellingShingle |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept Staub, Henrique Luiz multisystem inflammatory syndrome Kawasaki disease SARS-CoV-2 COVID-19 síndrome inflamatória multissistêmica doença de Kawasaki SARS-CoV-2 COVID-19 |
title_short |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept |
title_full |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept |
title_fullStr |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept |
title_full_unstemmed |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept |
title_sort |
Post-COVID-19 multisystem inflammatory syndrome: An evolving concept |
author |
Staub, Henrique Luiz |
author_facet |
Staub, Henrique Luiz Staub, Lia Portella |
author_role |
author |
author2 |
Staub, Lia Portella |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Staub, Henrique Luiz Staub, Lia Portella |
dc.subject.por.fl_str_mv |
multisystem inflammatory syndrome Kawasaki disease SARS-CoV-2 COVID-19 síndrome inflamatória multissistêmica doença de Kawasaki SARS-CoV-2 COVID-19 |
topic |
multisystem inflammatory syndrome Kawasaki disease SARS-CoV-2 COVID-19 síndrome inflamatória multissistêmica doença de Kawasaki SARS-CoV-2 COVID-19 |
description |
INTRODUCTION: A potential association of COVID-19 with inflammatory and autoimmune phenomena opens a new chapter in clinical practice. Among several inflammatory conditions described in the post-COVID-19 context, Kawasaki disease and a new condition named multisystem inflammatory syndrome stand out.AIMS: To review, in a practical and concise way, the concept and diagnostic criteria of multisystem inflammatory syndrome, the overlaps with Kawasaki disease, as well as the immunopathogenesis and treatment of this new and intriguing condition.METHODS: Literature review available in the Pubmed database, with emphasis on systematic reviews with meta-analyses.RESULTS: The multisystem inflammatory syndrome is a post-viral, multiorgan hyperinflammatory disorder. The condition is primarily pediatric, and the first cases were reported in England in May 2020. Diagnostic criteria are still imprecise, and include some Kawasaki disease-like manifestations. However, multisystem inflammatory syndrome differs from Kawasaki disease by usually affecting children above five years of age and of black or hispanic races; in clinical terms, it is distinguished by the high frequency of gastroenteropathy, cardiomyopathy and shock. Differential diagnosis includes bacterial sepsis, macrophage activation syndrome, and systemic forms of rheumatoid arthritis. An overexpression of interferons and other inflammatory cytokines pathogenically characterize the multisystem inflammatory syndrome. The disease is, as a rule, responsive to intensive care, steroids, intravenous immunoglobulin, and immunobiologics.CONCLUSIONS: Multisystem inflammatory syndrome is a new and complex hyperinflammatory condition associated with previous exposure to SARS-CoV-2. It shows interesting interfaces with Kawasaki disease. Despite the recent description, the literature is already quantitatively robust, and some pending issues in immunopathogenesis, diagnostic criteria and therapy should be shortly clarified. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-01-25 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/42436 10.15448/1980-6108.2022.1.42436 |
url |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/42436 |
identifier_str_mv |
10.15448/1980-6108.2022.1.42436 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/42436/27369 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2022 Scientia Medica http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2022 Scientia Medica http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
publisher.none.fl_str_mv |
Editora da PUCRS - ediPUCRS |
dc.source.none.fl_str_mv |
Scientia Medica; Vol. 32 No. 1 (2022): Single Volume; e42436 Scientia Medica; v. 32 n. 1 (2022): Volume Único; e42436 1980-6108 1806-5562 10.15448/1980-6108.2022.1 reponame:Scientia Medica (Porto Alegre. Online) instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) instacron:PUC_RS |
instname_str |
Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
instacron_str |
PUC_RS |
institution |
PUC_RS |
reponame_str |
Scientia Medica (Porto Alegre. Online) |
collection |
Scientia Medica (Porto Alegre. Online) |
repository.name.fl_str_mv |
Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) |
repository.mail.fl_str_mv |
scientiamedica@pucrs.br || editora.periodicos@pucrs.br |
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1809101752542167040 |