GuidelineArthritis & rheumatology (Hoboken, N.J.)2020
American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 1.
Guideline in Arthritis & rheumatology (Hoboken, N.J.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 222 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
222 citing papers in PubMed, 7 syntheses or guidelines pooled it, 532 citations in OpenAlex.
- The 2022 EULAR/ACR points to consider at the early stages of diagnosis and management of suspected haemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS).Annals of the rheumatic diseases · 2023Pooled it
- The 2022 EULAR/ACR Points to Consider at the Early Stages of Diagnosis and Management of Suspected Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome (HLH/MAS).Arthritis & rheumatology (Hoboken, N.J.) · 2023Pooled it
- International alliance and AGREE-ment of 71 clinical practice guidelines on the management of critical care patients with COVID-19: a living systematic review.Journal of clinical epidemiology · 2022Pooled it
- Adherence of Clinical Practice Guidelines for Pharmacologic Treatments of Hospitalized Patients With COVID-19 to Trustworthy Standards: A Systematic Review.JAMA network open · 2021Pooled it
- Neurological complications in pediatric patients with SARS-CoV-2 infection: a systematic review of the literature.Italian journal of pediatrics · 2021Pooled it
- Multisystem inflammatory syndrome in children: a microcosm of challenges and opportunities for translational bioinformatics in pediatric research.Current opinion in pediatrics · 2021Pooled it
- Childhood multisystem inflammatory syndrome associated with COVID-19 (MIS-C): a diagnostic and treatment guidance from the Rheumatology Study Group of the Italian Society of Pediatrics.Italian journal of pediatrics · 2021Guideline
- Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome.Pediatric research · 2026Article
- Commentary on multisystem inflammatory syndrome in children with tailored therapy and six-month outcome.Pediatric research · 2026Article
- Methylprednisolone-Induced Delayed and Sustained Bradycardia in Multisystem Inflammatory Syndrome in Children.Cureus · 2026Article
- Comparison of presentation, treatment and follow-up outcomes in first and second wave cohorts of multisystem inflammatory syndrome in children.Frontiers in pediatrics · 2026Article
- Effects of Electroacupuncture on Knee Osteoarthritis in Rats Through Suppressing p38 MAPK/ERK/CREB Pathway.Journal of inflammation research · 2026Article
- Hyperinflammatory status associated with COVID-19: clinical features of a pediatric series.Advances in rheumatology (London, England) · 2025Article
- Midterm cardiovascular outcomes in children with MIS-C compared to Kawasaki disease: a multicenter prospective cohort study.Scientific reports · 2025Article
- "Characteristics of children with multisystem inflammatory syndrome in children during different COVID-19 waves "Single centre Study".BMC pediatrics · 2025Observational
- Systematic Review and Meta-Analysis of Myocarditis Prevalence and Diagnostics in COVID-19:Acute, Post-COVID, and MIS-C (2020-2025).Journal of clinical medicine · 2025Review
- Comparison of Immunomodulatory Therapies for Cardiovascular Clinical and Inflammatory Markers Outcomes in Mild to Moderately Ill Hospitalized Multisystem Inflammatory Syndrome in Children Patients.Journal of cardiovascular development and disease · 2025Article
- Molecular Mechanisms and Pathophysiology of Myocardial Disease: Insights from Pediatric Inflammatory Multisystem Syndrome (PIMS) Associated with SARS-CoV-2.International journal of molecular sciences · 2025Article
- Unraveling the complexity in diagnosis and management of multisystem inflammatory syndrome in children with Kawasaki disease mimicry: a case report.Annals of medicine and surgery (2012) · 2025Article
- Advances in Understanding Inflammation and Tissue Damage: Markers of Persistent Sequelae in COVID-19 Patients.Journal of clinical medicine · 2025Review
162 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors at 13 institutions in 2 countries.
Funding
Abstract
objectiveTo provide guidance on the management of multisystem inflammatory syndrome in children (MIS-C), a condition characterized by fever, inflammation, and multiorgan dysfunction that manifests late in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and to provide recommendations for children with hyperinflammation during coronavirus disease 2019 (COVID-19), the acute, infectious phase of SARS-CoV-2 infection.
methodsA multidisciplinary task force was convened by the American College of Rheumatology (ACR) to provide guidance on the management of MIS-C associated with SARS-CoV-2 and hyperinflammation in COVID-19. The task force was composed of 9 pediatric rheumatologists, 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS-C and hyperinflammation in COVID-19 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved 2 rounds of anonymous voting and 2 webinars. A 9-point scale was used to determine the appropriateness of each statement (median scores of 1-3 for inappropriate, 4-6 for uncertain, and 7-9 for appropriate), and consensus was rated as low, moderate, or high based on dispersion of the votes along the numeric scale. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, as prespecified prior to voting.
resultsThe ACR task force approved a total of 128 guidance statements addressing the management of MIS-C and hyperinflammation in pediatric COVID-19. These statements were refined into 40 final clinical guidance statements, accompanied by a flow diagram depicting the diagnostic pathway for MIS-C.
conclusionOur understanding of SARS-CoV-2-related syndromes in the pediatric population continues to evolve. The guidance provided in this "living document" reflects currently available evidence, coupled with expert opinion, and will be revised as further evidence becomes available.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.