Inflammatory Symptoms of Multisystem Inflammatory Syndrome in children (MIS – C) and adolescents associated with COVID – 19: Analysis – Zhao – – Journal of Medical Virology


To conduct a systematic review and meta-analysis to identify inflammatory symptoms in comparisons of multisystemic inflammatory syndrome in children (MIS – C) vs. COVID – 19 severe / non-severe, MIS – severe C vs MIS – C noninvasive among MIS – C age groups.


Nine databases were studied for studies of inflammatory symptoms of MIS – C. Following quality studies, data were collated using a fixed or random effects model. Inflammatory symptoms included white blood cell count (WBC) or leukocytes, total lymphocyte count (ALC), total neutrophil count (ANC), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT) ), ferritin, D‐ reducing dimer, lactate dehydrogenase (LDH), fibrinogen and erythrocyte (ESR) for comparisons by severity and age.


787 MIS – C patients received twenty – one studies with 1735 participants. Compared with non-severe COVID patients – 19, MIS – C patients had lower ALC levels and higher ANC, CRP and D – dimer levels. Compared with very poor COVID patients – 19, LDH and PLT numbers were lower at MIS – C patients and higher ESR levels. Patients with severe MIS – C had higher levels of WBC, ANC, CRP, D – dimer and ferritin than non-severe MIS – C patients. For MIS – C, young children (0–5y) had lower CRP and ferritin levels than middle-aged / older children / adolescents.


Measurement of swelling symptoms may help clinicians to properly assess and diagnose MIS – C and the associated disorders.

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