Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 27, Number 5—May 2021

Multisystem Inflammatory Syndrome in Children, Chile, May–August 2020

Carmen Niño-TaravillaComments to Author , Hugo Otaola-Arca, Natalie Lara-Aguilera, Yuri Zuleta-Morales, and Paula Ortiz-Fritz
Author affiliations: Clinica INDISA, Santiago, Chile (C. Niño-Taravilla); Hospital Roberto del Río, Santiago (C. Niño-Taravilla, N. Lara-Aguilera, Y. Zuleta-Morales, P. Ortiz-Fritz); Clinica Alemana de Santiago, Santiago (H. Otaola-Arca)

Main Article

Table 1

Characteristics of 26 children with multisystem inflammatory syndrome associated with coronavirus disease, Chile, May–August 2020*

Characteristic Value
Median age, y (IQR)
6.5 (2.0–10.5)
M 15 (57.7)
11 (42.3)
Concurrent conditions
No 20 (76.9)
Obesity/overweight 3 (11.5)
Preterm 1 (3.8)
Acute lymphoblastic leukemia, Down syndrome
1 (3.8)
Chilean 19 (73.1)
Venezuelan 3 (11.5)
Peruvian 2 (7.7)
Colombian 1 (3.8)
1 (3.8)
Contact with SARS-CoV-2–positive patient
10 (38.5)
SARS-CoV-2 PCR results
Negative 18 (69.2)
Positive 7 (26.9)
1 (3.8)
SARS-CoV-2 serologic assay results
Negative 3 (16.7)
IgM– IgG+ 9 (50.0)
IgM+ IgG+
6 (33.3)
Positive PCR results for other co-infections
Rhinovirus 1 (3.8)
Rhinovirus and adenovirus
1 (3.8)
Signs and symptoms
Fever 26 (100.0)
Cough 7 (26.9)
Diarrhea 16 (61.5)
Vomiting 12 (46.2)
Abdominal pain 17 (65.4)
Conjunctivitis 15 (57.7)
Rash 16 (61.5)
Shock 24 (92.3)
Vasoplegic 18 (75.0)
Cardiogenic 1 (4.2)
Mixed 5 (20.8)
12 (46.2)
Invasive mechanical ventilation 10 (38.5)
Vasoactive drugs 13 (50.0)
Hyperimmune plasma 1 (3.8)
Corticoids 23 (88.5)
Intravenous immunoglobulin, doses
1 20 (76.9)
2 2 (7.7)
Tocilizumab 3 (11.5)
Infliximab 1 (3.8)
Acetylsalicylic acid 19 (73.1)
Low molecular weight heparin 19 (73.1)
Not used 7 (26.9)
Prophylaxis 17 (65.4)
Treatment 2 (7.7)
High-flow hemofiltration
1 (3.8)
Deaths 0
Median intensive care unit admission, d (IQR) 5 (2.0–7.0)
Median hospitalization duration, d (IQR)
10 (7.3–16.8)
Echocardiogram results
Normal 8 (30.8)
LV systolic dysfunction† 4 (15.4)
Pericardial effusion 3 (11.5)
LV systolic dysfunction and pericardial effusion 3 (11.5)
Hyperdynamic 1 (3.8)
Mild LV diastolic dysfunction‡ 2 (7.7)
Coronary alterations§ 5 (19.2)

*Values are no. (%), except as indicated. IQR, interquartile range; LV, left ventricle; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
†Defined as LV ejection <55%.
‡Defined as decreased E wave.
§Defined as: Z-score 2–2.5, dilatation; Z-score 2.5–5, small aneurysm; Z-score 5–10, medium aneurysm; Z-score >10; giant aneurysm (14).

Main Article

  1. Fu  L, Wang  B, Yuan  T, Chen  X, Ao  Y, Fitzpatrick  T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 2020;80:65665. DOIPubMedGoogle Scholar
  2. Ludvigsson  JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109:108895. DOIPubMedGoogle Scholar
  3. Riphagen  S, Gomez  X, Gonzalez-Martinez  C, Wilkinson  N, Theocharis  P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395:16078. DOIPubMedGoogle Scholar
  4. Royal College of Paediatrics and Child Health. Guidance: paediatric multisystem inflammatory syndrome temporally associated with COVID-19. 2020 [cited 2020 Aug 30].
  5. Feldstein  LR, Rose  EB, Horwitz  SM, Collins  JP, Newhams  MM, Son  MBF, et al.; Overcoming COVID-19 Investigators; CDC COVID-19 Response Team. Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med. 2020;383:33446. DOIPubMedGoogle Scholar
  6. Verdoni  L, Mazza  A, Gervasoni  A, Martelli  L, Ruggeri  M, Ciuffreda  M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395:17718. DOIPubMedGoogle Scholar
  7. Toubiana  J, Poirault  C, Corsia  A, Bajolle  F, Fourgeaud  J, Angoulvant  F, et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study. BMJ. 2020;369:m2094. DOIPubMedGoogle Scholar
  8. Cabrero-Hernández  M, García-Salido  A, Leoz-Gordillo  I, Alonso-Cadenas  JA, Gochi-Valdovinos  A, González Brabin  A, et al. Severe SARS-CoV-2 infection in children with suspected acute abdomen: a case series from a tertiary hospital in Spain. Pediatr Infect Dis J. 2020;39:e1958. DOIPubMedGoogle Scholar
  9. Whittaker  E, Bamford  A, Kenny  J, Kaforou  M, Jones  CE, Shah  P, et al.; PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA. 2020;324:25969. DOIPubMedGoogle Scholar
  10. Nakra  NA, Blumberg  DA, Herrera-Guerra  A, Lakshminrusimha  S. Multi-system inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: review of clinical presentation, hypothetical pathogenesis, and proposed management. Children (Basel). 2020;7:69. DOIPubMedGoogle Scholar
  11. Prata-Barbosa  A, Lima-Setta  F, Santos  GRD, Lanziotti  VS, de Castro  REV, de Souza  DC, et al.; Brazilian Research Network in Pediatric Intensive Care, (BRnet-PIC). Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study. J Pediatr (Rio J). 2020;96:58292. DOIPubMedGoogle Scholar
  12. Torres  JP, Izquierdo  G, Acuña  M, Pavez  D, Reyes  F, Fritis  A, et al. Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic. Int J Infect Dis. 2020;100:7581. DOIPubMedGoogle Scholar
  13. Minesterio de Salud . Protocolo Síndrome Inflamatorio Multisistémico en niños, niñas y adolescentes con SARS-CoV-2. 2020 [cited 2021 March 4].
  14. McCrindle  BW, Rowley  AH, Newburger  JW, Burns  JC, Bolger  AF, Gewitz  M, et al.; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; and Council on Epidemiology and Prevention. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017;135:e92799. DOIPubMedGoogle Scholar
  15. Radia  T, Williams  N, Agrawal  P, Harman  K, Weale  J, Cook  J, et al. Multi-system inflammatory syndrome in children & adolescents (MIS-C): a systematic review of clinical features and presentation. Paediatr Respir Rev. 2020 Aug 11 [Epub ahead of print].

Main Article

Page created: March 18, 2021
Page updated: April 22, 2021
Page reviewed: April 22, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.