Multisystemic inflammatory syndrome in children with COVID-19: a rheumatology perspective⋆

The coronavirus disease 2019 (COVID-19) produced by SARS-CoV-2 has taken on great importance in recent months, and is under constant investigation by different areas of medicine, including rheumatology, in search of the best evidence scientific. In the case of the paediatric population, it is particularly important as it was first thought that the impact of the pandemic in this population would be less due to the low presence of severe cases. Evidence is now being reported of clinical pictures in children with a diagnosis of COVID-19 who are characterised by an altered inflammatory state consisting of a storm of pro-inflammatory cytokines that produces manifestations similar to those presented in autoimmune diseases, such as Kawasaki disease. It has been called Multisystemic Inflammatory Syndrome in children, temporarily associated with SARS-CoV-2 which, in many cases requires hospitalisation in paediatric intensive care units and multidisciplinary management by various specialties. Resumen La enfermedad por coronavirus 2019 (COVID-19) producida por el SARS-CoV-2 ha tomado una gran importancia en los ultimos meses y se encuentra bajo constante investigacion por distintas areas de la medicina, incluida la reumatologia, en la busqueda de la mejor evidencia cientifica. En el caso de la poblacion pediatrica cobra especial importancia puesto que en un principio se pensaba que el impacto de la pandemia en esta poblacion seria menor, debido a la baja presencia de casos severos, pero la evidencia actual reporta la existencia de cuadros clinicos en ninos con diagnostico de COVID-19 que se caracterizan por un estado inflamatorio alterado consistente en una tormenta de citocinas proinflamatorias que produce manifestaciones similares a las presentadas en enfermedades autoinmunes como la enfermedad de Kawasaki. Se le ha denominado sindrome inflamatorio multisistemico en ninos asociado temporalmente con SARS-CoV-2, el cual en muchos casos precisa internacion en unidades de cuidados intensivos pediatricos y el manejo multidisciplinario por diversas especialidades.