Evidence map›Paper›PMID 33277976›Full record

GuidelineArthritis & rheumatology (Hoboken, N.J.)2021

American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2.

Lauren A Henderson, Scott W Canna, Kevin G Friedman, Mark Gorelik, Sivia K Lapidus, Hamid Bassiri, Edward M Behrens, Anne Ferris, Kate F Kernan, Grant S Schulert and 8 more

Open access · bronzeAbstract readConsensus StatementPractice Guideline
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Arthritis & rheumatology (Hoboken, N.J.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 215 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
215citing papers in PubMed, 9 pooled it
74.3field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

215 citing papers in PubMed, 9 syntheses or guidelines pooled it, 412 citations in OpenAlex.

  1. Post-MIS-C cardiovascular outcomes: a systematic review.European journal of pediatrics · 2026
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155 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 13 institutions in 2 countries.

Lauren A HendersonBoston Children's Hospital and Harvard Medical School, Boston, Massachusetts.ORCID https://orcid.org/0000-0003-0242-4029
Scott W CannaUPMC Children's Hospital of Pittsburgh and University of Pittsburgh, Pittsburgh, Pennsylvania.
Kevin G FriedmanBoston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Mark GorelikMorgan Stanley Children's Hospital and Columbia University, New York, New York.
Sivia K LapidusJoseph M. Sanzari Children's Hospital at Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey.ORCID https://orcid.org/0000-0001-8452-9937
Hamid BassiriChildren's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine.ORCID https://orcid.org/0000-0001-6532-8478
Edward M BehrensChildren's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine.ORCID https://orcid.org/0000-0002-4603-7963
Anne FerrisColumbia University Irving Medical Center, New York, New York.
Kate F KernanUniversity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Grant S SchulertCincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.ORCID https://orcid.org/0000-0001-5923-7051
Philip SeoJohns Hopkins University School of Medicine, Baltimore, Maryland.
Mary Beth F SonBoston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Adriana H TremouletUniversity of California San Diego and Rady Children's Hospital San Diego.
Rae S M YeungThe Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-2361-725X
Amy S MudanoUniversity of Alabama at Birmingham, Birmingham.
Amy S TurnerAmerican College of Rheumatology, Atlanta, Georgia.ORCID https://orcid.org/0000-0001-7695-2022
David R KarpUniversity of Texas Southwestern Medical Center, Dallas.ORCID https://orcid.org/0000-0002-9005-1690
Jay J MehtaChildren's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine.
Boston Children's Hospital · USChildren's Hospital of Philadelphia · USUniversity of Pittsburgh · USAmerican College of Rheumatology · USCincinnati Children's Hospital Medical Center · USColumbia University Irving Medical Center · USHackensack University Medical Center · USJohns Hopkins University · USMorgan Stanley Children's Hospital · USThe University of Texas Southwestern Medical Center · USUniversity of Alabama at Birmingham · USUniversity of California San Diego · USUniversity of Toronto · CA

Funding

Pediatric Critical Care Scientist Development ProgramK12HD047349 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI HEATHER T. KEENAN, Kevin M Watt · 2004 to 2026
$17.0M
Diagnosis of MIS-C in febrile childrenR61HD105594 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI BASSIRI, HAMID, ODOM JOHN, AUDREY RAGAN · 2021 to 2022
$1.8M
The Reprogramming of Regulatory T cells to a Th17 Phenotype in Systemic Juvenile Idiopathic ArthritisK08AR073339 · NIAMS · BOSTON CHILDREN'S HOSPITAL · PI HENDERSON, LAUREN A · 2018 to 2022
$840k
NIAMS NIH HHS K08 AR073339NICHD NIH HHS K12 HD047349NICHD NIH HHS R61 HD105594
6 · The paper itself

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. Recommendations are also provided for children with hyperinflammation during coronavirus disease 2019 (COVID-19), the acute, infectious phase of SARS-CoV-2 infection.

methodsThe Task Force was composed of 9 pediatric rheumatologists and 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 anonymous voting and webinar discussion. 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). Consensus was rated as low, moderate, or high based on dispersion of the votes. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, which were prespecified before voting.

resultsThe first version of the guidance was approved in June 2020, and consisted of 40 final guidance statements accompanied by a flow diagram depicting the diagnostic pathway for MIS-C. The document was revised in November 2020, and a new flow diagram with recommendations for initial immunomodulatory treatment of MIS-C was added.

conclusionOur understanding of SARS-CoV-2-related syndromes in the pediatric population continues to evolve. This guidance document reflects currently available evidence coupled with expert opinion, and will be revised as further evidence becomes available.

Indexed as

AdolescentAdvisory CommitteesAnticoagulantsAntirheumatic AgentsChildChild, PreschoolCOVID-19Delphi TechniqueDiagnosis, DifferentialGlucocorticoidsHumansImmunoglobulins, IntravenousImmunologic FactorsInfantInfant, NewbornInflammationAnticoagulantsAntirheumatic AgentsGlucocorticoidsImmunoglobulins, IntravenousImmunologic FactorsInterleukin 1 Receptor Antagonist ProteinPlatelet Aggregation Inhibitors

Identifiers

PMID33277976
PMCPMC8559788
OpenAlexW3107442582

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.