Prevalence of paediatric hyperinflammatory conditions in paediatric and adolescent hospitalized COVID-19 patients: a systematic review and meta-analysis

APMIS. 2022 Feb;130(2):101-110. doi: 10.1111/apm.13199. Epub 2021 Dec 22.


In the milieu of coronavirus disease 2019 (COVID-19), there are increasing reports of paediatric hyperinflammatory conditions (PHICs), including multisystem inflammatory syndrome in children (MIS-C), paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and Kawasaki disease (KD). Few analyses of PHIC prevalence in paediatric and adolescent hospitalized COVID-19 patients exist. The purpose of this study was to perform a meta-analysis to determine a pooled prevalence estimate of PHICs in paediatric and adolescent hospitalized patients admitted for treatment due to COVID-19. Individual studies were retrieved from PubMed/Medline, EMBASE and Cochrane databases. Relevant prevalence, baseline, treatment and outcome data were extracted using a standardized datasheet. The systematic review and meta-analysis were conducted as per the PRISMA and MOOSE guidelines. Overall, 14 studies with 2202 patients admitted for treatment due to COVID-19, among whom 780 were diagnosed with PHICs, were included. The crude estimate of prevalence was 35.42%, and the pooled estimate of prevalence was 29% (random pooled ES = 0.29; 95% CIs = 0.18-0.42; p < 0.0001; z = 7.45). A sizeable proportion of paediatric and adolescent hospitalized patients admitted for treatment due to COVID-19 are diagnosed with a PHIC warranting a high index of clinical suspicion for PHICs. Further studies are required to validate these findings.

Keywords: COVID-19; Kawasaki disease; MIS-C; immunology; prevalence.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • COVID-19 / immunology
  • COVID-19 / therapy
  • COVID-19 / virology
  • Child
  • Child, Preschool
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Male
  • Mucocutaneous Lymph Node Syndrome / epidemiology*
  • Mucocutaneous Lymph Node Syndrome / immunology
  • Mucocutaneous Lymph Node Syndrome / therapy
  • Mucocutaneous Lymph Node Syndrome / virology
  • Prevalence
  • SARS-CoV-2 / physiology
  • Systemic Inflammatory Response Syndrome / epidemiology*
  • Systemic Inflammatory Response Syndrome / immunology
  • Systemic Inflammatory Response Syndrome / therapy
  • Systemic Inflammatory Response Syndrome / virology

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related

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