• Serhat Emeksiz, Banu Çelikel Acar, Ayşe Esin Kibar, Aslınur Özkaya Parlakay, Oktay Perk, Gülsüm İclal Bayhan, Güzin Cinel, Namık Özbek, Müjdem Nur Azılı, Elif Çelikel, Halise Akça, Emine Dibek Mısırlıoğlu, Umut Selda Bayrakçı, İbrahim İlker Çetin, Neşe Çıtak KurtAyşegülADepartment of Pediatric Neurology, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Turkey., Mehmet Boyraz, Şamil Hızlı, and Emrah Şenel.
• Department of Pediatric Intensive Care Unit, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
• Int. J. Clin. Pract. 2021 Sep 1; 75 (9): e14471.

ObjectiveAlthough the initial reports of COVID-19 cases in children described that children were largely protected from severe manifestations, clusters of paediatric cases of severe systemic hyperinflammation and shock related to severe acute respiratory syndrome coronavirus 2 infection began to be reported in the latter half of April 2020. A novel syndrome called "multisystem inflammatory syndrome in children" (MIS-C) shares common clinical features with other well-defined syndromes, including Kawasaki disease, toxic shock syndrome and secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome. Our objective was to develop a protocol for the evaluation, treatment and follow-up of patients with MIS-C.MethodsThe protocol was developed by a multidisciplinary team. We convened a multidisciplinary working group with representation from the departments of paediatric critical care, cardiology, rheumatology, surgery, gastroenterology, haematology, immunology, infectious disease and neurology. Our protocol and recommendations were based on the literature and our experiences with multisystem inflammatory syndrome in children. After an agreement was reached and the protocol was implemented, revisions were made on the basis of expert feedback.ConclusionChildren may experience acute cardiac decompensation or other organ system failure due to this severe inflammatory condition. Therefore, patients with severe symptoms of MIS-C should be managed in a paediatric intensive care setting, as rapid clinical deterioration may occur. Therapeutic approaches for MIS-C should be tailored depending on the patients' phenotypes. Plasmapheresis may be useful as a standard treatment to control hypercytokinemia in cases of MIS-C with severe symptoms. Long-term follow-up of patients with cardiac involvement is required to identify any sequelae of MIS-C.© 2021 John Wiley & Sons Ltd.

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