{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:03:13Z","timestamp":1787166193183,"version":"build-2736575974"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T00:00:00Z","timestamp":1666051200000},"content-version":"unspecified","delay-in-days":290,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0950268822001522_sec_a1\" sec-type=\"intro\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Here, we are sharing our second report about children affected by Multisystem Inflammatory Syndrome in Children (MIS-C). The aim of the present study was to update our knowledge about children with MIS-C. Furthermore, we tried to compare clinical manifestations, laboratory features and final outcome of patients based on disease severity, in order to better understanding of the nature of this novel syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0950268822001522_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study was conducted at Children's Medical Center Hospital, the hub of excellence in paediatrics in Iran, located in Tehran, Iran. We reviewed medical records of children admitted to the hospital with the diagnosis of MIS-C from July 2020 to October 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0950268822001522_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and twenty-two patients enrolled the study. Ninety-seven (79.5%) patients had mild to moderate MIS-C (MIS-C without overlap with KD (\n                      <jats:italic>n<\/jats:italic>\n                      = 80); MIS-C overlapping with KD (\n                      <jats:italic>n<\/jats:italic>\n                      = 17)) and 25 (20.5%) patients showed severe MIS-C. The mean age of all patients was 6.4 \u00b1 4.0 years. Nausea and vomiting (53.3%), skin rash (49.6%), abdominal pain (46.7%) and conjunctivitis (41.8%) were also frequently seen Headache, chest pain, tachypnea and respiratory distress were significantly more common in patients with severe MIS-C (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.021,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001 and\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001, respectively). Positive anti-N severe acute respiratory syndrome coronavirus 2 IgM and IgG were detected in 14 (33.3%) and 23 (46.9%) tested patients, respectively. Albumin, and vitamin D levels in children with severe MISC were significantly lower than children with mild to moderate MIS-C (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.0001,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.05). Unfortunately, 2 (1.6%) of 122 patients died and both had severe MIS-C.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0950268822001522_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with MIS-C in our region suffer from wide range of signs and symptoms. Among laboratory parameters, hypoalbuminemia and low vitamin D levels may predict a more severe course of the disease. Coronary artery dilation is frequently seen among all patients, regardless of disease severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0950268822001522","type":"journal-article","created":{"date-parts":[[2022,10,18]],"date-time":"2022-10-18T05:00:59Z","timestamp":1666069259000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":20,"title":["Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in children: update and new insights from the second report of an Iranian referral hospital"],"prefix":"10.1017","volume":"150","author":[{"given":"Setareh","family":"Mamishi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrnaz","family":"Olfat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Pourakbari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Eshaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Reza","family":"Abdolsalehi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ali","family":"Shahbabaie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Jalali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Safari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3557-6432","authenticated-orcid":false,"given":"Shima","family":"Mahmoudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,10,18]]},"reference":[{"key":"S0950268822001522_ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-020-01327-0"},{"key":"S0950268822001522_ref8","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20210446"},{"key":"S0950268822001522_ref24","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.648546"},{"key":"S0950268822001522_ref27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6583"},{"key":"S0950268822001522_ref18","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002598"},{"key":"S0950268822001522_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15270"},{"key":"S0950268822001522_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001017"},{"key":"S0950268822001522_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S095026882000196X"},{"key":"S0950268822001522_ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-021-01602-3"},{"key":"S0950268822001522_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03766-6"},{"key":"S0950268822001522_ref14","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000974"},{"key":"S0950268822001522_ref30","doi-asserted-by":"publisher","DOI":"10.3390\/children7070069"},{"key":"S0950268822001522_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2020.08.001"},{"key":"S0950268822001522_ref3","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07200-0"},{"key":"S0950268822001522_ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10369"},{"key":"S0950268822001522_ref21","doi-asserted-by":"publisher","DOI":"10.1172\/JCI141113"},{"key":"S0950268822001522_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2020.06.045"},{"key":"S0950268822001522_ref13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021680"},{"key":"S0950268822001522_ref17","unstructured":"17. Centers for Disease Control and Prevention. Emergency preparedness and response: health alert network. Published 14 May 2020. Available at https:\/\/emergency.cdc.gov\/han\/2020\/han00432.asp (Accessed 22 May 2020)."},{"key":"S0950268822001522_ref7","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/S0140-6736(20)31094-1","article-title":"Hyperinflammatory shock in children during COVID-19 pandemic","volume":"395","author":"Riphagen","year":"2020","journal-title":"The Lancet"},{"key":"S0950268822001522_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14450"},{"key":"S0950268822001522_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-020-04921-9"},{"key":"S0950268822001522_ref6","doi-asserted-by":"publisher","DOI":"10.1101\/2020.05.10.20097394"},{"key":"S0950268822001522_ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.625377"},{"key":"S0950268822001522_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31103-X"},{"key":"S0950268822001522_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-020-2026-0"},{"key":"S0950268822001522_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104715"},{"key":"S0950268822001522_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.08.062"},{"key":"S0950268822001522_ref26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1008874"},{"key":"S0950268822001522_ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s10875-020-00824-4"},{"key":"S0950268822001522_ref29","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217960"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268822001522","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T03:32:29Z","timestamp":1668483149000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268822001522\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":31,"alternative-id":["S0950268822001522"],"URL":"https:\/\/doi.org\/10.1017\/s0950268822001522","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e179"}}