Pediatric multisystem inflammatory syndrome associated with COVID-19 A review of clinical presentation and pathogenesis.

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Isabel Carrasco
Greta Munoz
Gabriela Carrasco


Introduction: Multisystem inflammatory syndrome (MIS) is a hyperinflammatory disorder that has emerged as a significant concern during the COVID-19 pandemic. This syndrome also affects the pediatric population, and notifications of cases of multisystem inflammatory syndrome in children (MIS-C) have increased worldwide. An exceptionally high incidence of Hispanic and Afro-descendant patients is observed, reaching 23% in Latin America. Although a direct link between MIS-C and the SARS-CoV-2 has not been established, research suggests a late immunological connection mediated by an imbalance in the expression of Th17 cells/Thregs, autoantibodies, and immune complexes, especially in genetically susceptible individuals and those with an altered endogenous environment.

Methods: In this theoretical review, an exhaustive bibliographic search was conducted in the MEDLINE, LILACS, and Google Scholar databases. Relevant data were collected on the pathogenic and immunological mechanisms that contribute to the development of MIS-C, as well as information on its clinical presentation and relationship with other childhood inflammatory syndromes.

Results: MIS-C predominantly affects the digestive, cardiovascular, and neurological systems and is associated with fever, significantly elevated inflammatory marker levels, and symptoms of organ dysfunction. This syndrome shares similarities with Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. Research has confirmed that MIS-C patients present unique immune and laboratory profiles, establishing it as a distinct clinical entity.

Conclusions: This review highlights the importance of recognizing multisystem inflammatory syndrome in children infected with SARS-CoV-2. The causal connection has yet to be fully established, but initial data support the existence of MIS-C as a unique clinical entity. Understanding the immunological mechanisms and distinctive clinical characteristics of this disease is essential for its early identification and appropriate management in the pediatric population.


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Carrasco Ronquillo, I., Muñoz López , G., & Carrasco Ronquillo , G. (2023). Pediatric multisystem inflammatory syndrome associated with COVID-19: A review of clinical presentation and pathogenesis. Revista Ecuatoriana De Pediatría, 24(3), 245-259.
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