Pediatric multisystem inflammatory syndrome (MIS-C) after viral infection beyond COVID-19

Abstract

Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but potentially severe complication associated with SARS-CoV-2 infection, characterized by systemic inflammation and multi-organ involvement. This study aimed to synthesize available evidence regarding the epidemiological, pathophysiological, clinical, prognostic, and therapeutic aspects of MIS-C through a literature review. The findings indicate that the syndrome typically occurs two to six weeks after viral infection and presents heterogeneous clinical manifestations, including persistent fever, gastrointestinal and cardiovascular involvement, and markedly elevated inflammatory markers. Admission to intensive care units is frequently required, although mortality remains relatively low when early diagnosis is achieved. Key predictors of severity include elevated C-reactive protein, ferritin levels, lymphopenia, and ventricular dysfunction. Treatment is primarily based on intravenous immunoglobulin and corticosteroids, with favorable clinical outcomes. Additionally, some patients may develop persistent symptoms consistent with long COVID. In conclusion, MIS-C represents a diagnostic and therapeutic challenge, and early recognition combined with evidence-based management is essential to improve clinical outcomes.