Post-COVID-19 multisystem inflammatory syndrome: An evolving concept

Detalhes bibliográficos
Autor(a) principal: Staub, Henrique Luiz
Data de Publicação: 2022
Outros Autores: Staub, Lia Portella
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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spelling 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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