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However, since mid-April 2020, clusters of pediatric cases of severe systemic hyperinflammation and shock epidemiologically linked with COVID-19 have been reported. This condition was named as SARS-Cov-2-associated multisystem inflammatory syndrome in children and showed similarities to Kawasaki disease. Here, we present a narrative review of cases reported in literature and we discuss the clinical acute and follow-up management of these patients. Patients with SARS-Cov-2-associated multisystem inflammatory syndrome frequently presented with persistent fever, gastrointestinal symptoms, polymorphic rash, conjunctivitis, and mucosal changes. Elevated inflammatory markers and evidence of cytokine storm were frequently observed. A subset of these patients also presented with hypotension and shock (20\u2013100%) from either acute myocardial dysfunction or systemic hyperinflammation\/vasodilation. Coronary artery dilation or aneurysms have been described in 6\u201324%, and arrhythmias in 7\u201360%. Cardiac support, immunomodulation, and anticoagulation are the key aspects for the management of the acute phase. Long-term structured follow-up of these patients is required due to the unclear prognosis and risk of progression of cardiac manifestations.<\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Multisystem inflammatory syndrome is a novel syndrome related to SARS-CoV-2 infection. Evidence is still scarce but rapidly emerging in the literature. Cardiac manifestations are frequent, including myocardial and coronary involvement, and need to be carefully identified and monitored over time.\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Multisystem inflammatory syndrome in children (MIS-C) has been described associated with SARS-CoV-2.<\/jats:italic>\n                              <jats:bold>What is New:<\/jats:bold>\n                              \u2022\n                              <jats:italic>Patients with MIS-C often present with fever, gastrointestinal symptoms, and shock.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Cardiac involvement is found in a high proportion of these patients, including ventricular dysfunction, coronary artery dilation or aneurysm, and arrhythmias.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Management is based on expert consensus and includes cardiac support, immunomodulatory agents, and anticoagulation.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Long-term follow-up is required due to the unclear prognosis and risk of progression of cardiac manifestation.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-020-03766-6","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T07:02:42Z","timestamp":1597474962000},"page":"307-322","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":306,"title":["Cardiac manifestations in SARS-CoV-2-associated multisystem inflammatory syndrome in children: a comprehensive review and proposed clinical approach"],"prefix":"10.1007","volume":"180","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7109-0582","authenticated-orcid":false,"given":"Francesca","family":"Sperotto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin G.","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Beth F.","family":"Son","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina J.","family":"VanderPluym","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane W.","family":"Newburger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Dionne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,15]]},"reference":[{"key":"3766_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1542\/peds.2020-0702","volume":"145","author":"Y Dong","year":"2020","unstructured":"Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, Tong S (2020) Epidemiology of COVID-19 among children in China. 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