Multisystem inflammatory syndrome in children in South Africa

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a relatively new clinical entity that has been described in children during the SARS-CoV-2 pandemic. Initial reports emerged around mid-April 2020 and described children presenting with this hyperinflammatory syndrome 4 - 6 weeks after the peak of COVID19 infections.[1-4] These studies were supported by later reports that showed that as the number of COVID-19 infections declined, so did the number of MIS-C cases. The Western Cape, being the initial epicentre of COVID-19 infections within South Africa, had their first MIS-C cases at the beginning of June 2020. Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and MIS-C are synonymous names given to this syndrome. Despite the differing names and minor differences in case definitions, they include children who present with fever, evidence of inflammation and multi-organ involvement after SARS-CoV-2 exposure. The high incidence of SARS-CoV-2-positive serology as well as the increased markers of hyperinflammation suggest that the syndrome is a post-infectious inflammatory process.