MIS-C associated with COVID-19:A systematic review of the immunopathological mechanism

Rodríguez-Alcocer J.; Delgado M.; Portilla-Cusi F.; Soto N.; Carpio J.; Obando-Pereda G. · Archivos de Alergia e Inmunologia Clinica (2022) · DOI: 10.53108/aaic/202204/0164-0169

Resumen

Introduction.The development of the COVID-19 pandemic is associated with diseases and conditions such as multisystem inflammatory syndrome in children (MISC), which is mild in most patients; however, MIS-C produces a severe post-SARS-Cov-2 inflammatory response in children (<12) who presented an asymptomatic infection, manifesting as an uncontrolled inflammatory response with multi-organ involvement.There is evidence of a resemblance between the signs and symptoms of MIS-C and kD (Kawasaki disease); in this way, within the differentiation aspects, the recognition of the phenotype is considered as the susceptibility of each one. Materials and methods. A systematic review was carried out based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines, following eligibility criteria according to diagnoses of MIS-C according to the WHO and the CDC; studies in which markers of inflammation have been analyzed; studies in which proinflammatory cytokines and reactive autoantibodies have been profiled. In this way, selected articles from databases published from 2020 to the present (2022) were included. Results. Eight basic studies were included for the development of the review, having as a synthesis of information the references to antibodies, markers of inflammation and similarity relationship between MIS-C and KD, which were parameters that encompass the etiology of MIS-C with the COVID-19. Conclusions.There is evidence of correlation of inflammatory markers such as WBC, ALC, ANC, PLT, CRP, ferritin, D-dimer levels, LDH, fibrinogen and ESR with MIS-C. Within the comparison of MIS-C and Kawasaki disease, patients with MIS‐C had higher levels of white blood cells, CRP (mg/L), D-dimer (μg/ml), and ferritin (ng/ml) and lower levels of LAC; in this way, the differential diagnosis has been determined by cardiovascular and gastrointestinal problems. In relation to COVID-19, the appearance of IgG antibodies does not rule out the possibility of autoimmune diseases.

Instituciones: Universidad Católica de Santa María