MULTISYSTEM INFLAMMATORY SYNDROME ASSOCIATED WITH NOVEL CORONAVIRUS INFECTION (COVID-19) IN CHILDREN

The novel coronavirus infection potentiates the development in genetically predisposed patients of a severe systemic inflammatory syndrome, reminiscent of Kawasaki disease (CD), often accompanied by shock. First, there is a fever and an increase in biomarkers of systemic inflammation and myocardial damage, then acute left ventricular failure occurs very quickly, and in some patients signs of secondary hemophagocytic syndrome (HPS) join. Such patients are usually older than 5 years, they often have gastrointestinal symptoms, blood tests show a shift in the leukocyte formula to the left, an increase in ESR, thrombocytosis or thrombocytopenia, a sharp increase in the level of CRP, LDH, ferritin, troponin, D-dimer and, in contrast to the classical BC, sometimes the level of procalcitonin rises. Coronary dilation occurs in a subset of these patients. A fairly effective treatment is the introduction of human IVIG, with signs of secondary HPS - the introduction of dexamethasone, or pulse therapy with methylprednisolone. Further research is needed to investigate the mechanisms of AIM, hyperimmune vasculitis, and cardiac involvement in COVID-19 infection, which may be useful in preventing adverse outcomes in children.

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