{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:19:58Z","timestamp":1781194798096,"version":"3.54.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ital J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Sicily, the first wave of COVID-19 showed a low epidemic impact in paediatric population, while the second and the third waves had a higher impact on clinical presentation of COVID-19 in children and a significantly higher severe outcome in patients with multisystem inflammatory syndrome in children (MIS-C), with a frequent life-threatening progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe a cohort of 22 Sicilian children (11\u00a0M; 11 F; age: 1.4\u201314\u00a0years), presenting with clinical features compatible with MIS-C. Patients with negative swab had a history of recent personal or parental infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The following diagnostic criteria were detected: fever (100%); cheilitis and\/or pharyngeal hyperaemia (86%); latero-cervical lymphadenitis (82%); rash (73%); abdominal pain and\/or vomiting and\/or diarrhoea (64%); conjunctivitis (64%); hands and feet oedema (18%). 59% showed cardiac involvement (6 pericardial effusion; 8 mitral valve insufficiency; 4 insufficiency of two valves; 3 coronary artery lesions (CAL)). In all the patients, treatment was started within 72\u00a0h after the admission, with intravenous immunoglobulins (IVIG) (2\u00a0g\/Kg\/dose), methylprednisolone (2\u00a0mg\/Kg\/day in 73% of patients; 30\u00a0mg\/Kg\/day for 3\u00a0days, followed by 2\u00a0mg\/Kg\/day in 27% of patients). Two patients were treated with enoxaparin. Two patients with shock, were additionally treated with vasoactive drugs, albumin, diuretics. Cardiac involvement evolved into the complete resolution of lesions in most of the patients. All the patients were included in a follow-up, to investigate on clinical outcome and resolution of organ involvement. Cardiac valve insufficiency persisted only in 18% of children, CAL persisted only in 33% of children with coronary involvement, however without the evolution into aneurisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The preferred treatment strategy was more aggressive at the diagnosis of MIS-C, to block the cytokine cascade. Most of our patients, in fact, received a first-line treatment with IVIG and steroids. This approach could explain the favourable prognosis, the rapid restoring of cardiac function also in patients with MAS or shock, and the good outcome during the 10\u00a0months follow-up in all the patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13052-023-01416-9","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T03:04:11Z","timestamp":1679540651000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Ten-month follow-up of patients with covid-19 temporally related multi-system inflammatory syndrome in children: the experience of the children hospital of Palermo"],"prefix":"10.1186","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7777-1239","authenticated-orcid":false,"given":"Maria Cristina","family":"Maggio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Concetta","family":"Failla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina Gioacchina","family":"Campione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Alaimo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Corsello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"issue":"4","key":"1416_CR1","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1002\/art.42062","volume":"74","author":"LA Henderson","year":"2022","unstructured":"Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, Bassiri H, Behrens EM, Kernan KF, Schulert GS, Seo P, Son MBF, Tremoulet AH, VanderPluym C, Yeung RSM, Mudano AS, Turner AS, Karp DR, Mehta JJ. American college of rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: Version 3. Arthritis Rheumatol. 2022;74(4):e1\u201320. https:\/\/doi.org\/10.1002\/art.42062. (Epub 2022 Feb 3. PMID: 35118829; PMCID: PMC9011620).","journal-title":"Arthritis Rheumatol"},{"issue":"1","key":"1416_CR2","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jaci.2020.10.008","volume":"147","author":"M Noval Rivas","year":"2021","unstructured":"Noval Rivas M, Porritt RA, Cheng MH, et al. COVID-19-associated multi-system inflammatory syndrome in children (MIS-C): A novel disease that mimics toxic shock syndrome-the superantigen hypothesis. 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The approval by ethics committee was not applicable because the data retrospectively collected were all the items needed by the follow-up of these patients and by a good clinical practice for children with MIS-C. No experimental drugs were employed, and no blood samples, other than all required in consideration of the standards of care, were done. Written informed consent was obtained from a parent and\/or legal guardian. The parents wrote the informed consent on ethics approval and consent. The written consent is in the documents in the hospital \u201cG. Di Cristina\u201d, ARNAS Palermo, Italy. The consent was collected in the clinical documents. The approval by the ethics committee was not required for the type of work; it was a collection and analysis of laboratory, clinical, instrumental evaluations required for a good clinical practice.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. Consent was required to the patients\u2019 parents.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All the authors declare no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"37"}}