neonatal multisystem inflammatory syndrome consequent to perinatal sars-covid-2- infection: a narrative review study

Several studies have described multisystem inflammatory syndrome (mis) in children, but very few investigations presented this syndrome among neonates (mis-n). the present study has reviewed the current knowledge about mis-n, its etiology, symptoms, and outcomes to attract special attention with an eye on earlier diagnosis and treatment of newborns affected by perinatal sars-cov-2-infection. a narrative review study was conducted (tehran, iran, 2021). all types of full english articles (up to october 1 2021) were included. detailed research on academic search engines was performed. the implemented mesh-based keywords were sars-covid-2 or covid-19 or coronavirus and neonate or neonatal or newborn and multisystem inflammatory syndrome or mis-n or inflammatory response syndrome and pregnancy or perinatal or prenatal. finally, 15 full-text articles were included that met the eligibility criteria. available data related to the disease, its etiology, presentations, and its outcome were collected and discussed. the cause of mis-n is the transmission or production of sars-cov2 antibodies in response to sars-cov2 infection. by involving different organs, the clinical manifestations of mis-n may mimic sepsis, toxic shock syndrome, rds, kawasaki disease, necrotizing enterocolitis, myocarditis, meningitis/encephalitis, aortic thrombosis, etc. besides the clinical presentations, detecting reactive anti-sars-cov-2 igg antibodies could be a notable clue in mis-n diagnosis. supportive therapy, suppressing the autoimmune and inflammatory responses, anti-platelet agents, and anticoagulants were reported as the effective therapeutic agents to improve the outcome. the present study highlighted the possibility of mis-n as an infrequent but severe syndrome consequent to perinatal covid-19 infection. although the diagnosis is still controversial, clinical suspicion, laboratory findings, and early treatment initiation could improve the outcome of this immunological disease.