Coronavirus Disease 2019-Related Multisystem Inflammatory Syndrome in Children: A Systematic Review and Meta-Analysis

Table 1

Meta-analysis results.

Outcome indicators	Number of included studies	Sample size	Heterogeneity			Effect of model	Meta-analysis results
			values	I^2	t^2		R% (95% CI)
Clinical features
Fever	47	1367	0.86	0	0.71	Fixed	99.94% (99.74%-100%^)
Rash	46	1953	<0.01	64.30%	0.0118	Random	59.34% (54.73%-63.87%)
Dry cracked lips	30	1634	<0.01	77.10%	0.0181	Random	46.37% (39.97%-52.83%^)
Conjunctival injection	37	1799	<0.01	65.70%	0.0112	Random	55.23% (50.22%-60.19%^)
Swollen hands and feet	24	998	<0.01	81.30%	0.0291	Random	28.75% (21.46%-36.64%^)
Lymphadenopathy	21	1513	<0.01	86.60%	0.0267	Random	27.07% (19.87%-34.93%^)
Gastrointestinal symptoms	51	2126	<0.01	80.00%	0.0264	Random	82.72% (78.19%-86.81%)
Neurological symptoms	31	1668	<0.01	82.10%	0.0248	Random	28.87% (22.76%-35.40%)
Respiratory symptoms	36	1753	<0.01	86.85%	0.0378	Random	53.02% (45.28%-60.68%)
Arthralgias	9	393	0.03	53.50%	0.0084	Random	14.16% (8.4%-21.12%)
Typical Kawasaki disease	32	1481	<0.01	92.60%	0.0798	Random	17.32% (15.44%-19.29%)
Atypical Kawasaki disease	18	559	<0.01	91.60%	0.0981	Random	36.19% (21.90%-51.86%)
Cardiac damage
Coronary artery dilation	35	927	<0.01	64.20%	0.0186	Random	17.83% (13.29%-22.87%)
Aneurysm	26	734	<0.01	66.40%	0.0188	Random	6.85% (3.68%-10.92%)
Pericardial effusion	24	1244	<0.01	69.30%	0.0137	Random	20.97% (15.69%-26.79%)
Myocarditis	20	930	<0.01	92.10%	0.098	Random	35.97% (32.92%-39.08)
cardiac systolic function affects	35	1308	<0.01	85.70%	0.049	Random	56.32% (47.65%-64.80%)
High troponin	30	1485	<0.01	95.50%	0.1324	Random	76.34% (63.27%-87.27%)
BNP	31	1554	<0.01	94.20%	0.0971	Random	84.65% (74.95%-92.31%)
Organ damage
Liver function damage	16	411	<0.01	82.20%	0.0524	Random	46.29% (32.78%-60.08%)
Renal function	26	1463	<0.01	84.90%	0.0296	Random	27.67% (20.83%-35.08%)
Laboratory inspection
Leukocytosis	12	401	<0.01	73.30%	0.0394	Random	55.30% (40.47%-69.66%)
Leukopenia	10	417	<0.01	82.90%	0.0514	Random	4.40% (0.14%-14.13%)
Reduced lymphocytes	28	1206	<0.01	89.00%	0.0612	Random	61.51% (50.73%-71.74%)
Elevated platelets	11	421	0.05	44.90%	0.0093	Fixed	10.35% (7.62%-13.43%)
Thrombocytopenia	20	1368	<0.01	87.70%	0.0326	Random	26.42% (18.19%-35.58%
CRP rise	34	1087	<0.01	82.20%	0.0397	Random	98.5% (95.04%-99.65%)
Elevated ferritin	28	884	<0.01	84.00%	0.0483	Random	86.79% (79.32%-92.79%)
Elevated ESR	13	475	<0.01	75.90%	0.0253	Random	82.44% (73.47%-89.89%)
Elevated PCT	17	597	<0.01	81.80%	0.0414	Random	85.10% (75.65%-92.55%)
Elevated FIB	13	414	<0.01	86.80%	0.0658	Random	87.01% (73.97%-95.98%)
hypoalbuminemia	14	457	<0.01	82.70%	0.0443	Random	77.92% (66.00%-87.85%)
Elevated LDH	10	478	<0.01	98.00%	0.3994	Random	80.59% (42.53%-99.73%)
Elevated IL-6	11	527	<0.01	91.90%	0.0814	Random	89.3% (75.3%-97.88%)
Pulmonary ground glass change	14	271	<0.01	71.00%	0.0358	Random	24.69% (19.74%-29.99%)
Severe disease and mortality
PICU	48	1949	<0.01	83.40%	0.0346	Random	72.79% (66.75%-78.44%)
Shock	42	1804	<0.01	85.30%	0.0384	Random	55.68% (48.50%-62.74%)
Mortality	45	2010	<0.01	39.00%	0.0039	Fixed	1.00%(0.61%-1.48%)
Treatment
Invasive mechanical ventilation	46	1565	<0.01	85.45%	0.0451	Random	22.68%(16.91%29.02%)
ECMO	37	1078	<0.01	54.90%	0.0109	Random	0.48% (0.03%-1.42%)
IVIG	47	1959	<0.01	86.00%	0.0413	Random	82.15% (76.53%-87.14%)
Aspirin	20	592	<0.01	89.20%	0.0888	Random	67.97% (53.77%-80.64%)
Glucocorticoid	40	1869	<0.01	86.90%	0.0401	Random	59.32% (52.02%-66.43%)
Vasoactive agent	23	955	<0.01	83.90%	0.0493	Random	45.79% (42.62%-48.97%)
Positive inotropic	24	939	<0.01	87.40%	0.0493	Random	58.99% (48.57%-69.02%)
IL-1 receptor antagonist	16	516	<0.01	76.50%	0.0293	Random	3.61% (0.68%-8.73%)
IL-6 receptor antagonist	18	518	<0.01	91.30%	0.1060	Random	10.9% (2.79%-23.42%)
Infliximab	14	538	<0.10	59.80%	0.013	Random	6.68% (3.03%-11.62%)
Antibiotic	19	528	<0.11	81.9	0.0562	Random	90.96% (82.29%-96.92%)

CRP = C-reactive protein; ESR = erythrocyte sedimentation rate; PCT = procalcitonin; FIB = fibrinogen; LDH = lactate dehydrogenase; IL-6 = interleukin-6; BNP = B type natriuretic peptide; ECMO = extracorporeal membrane oxygenation; IVIG = intravenous immunoglobulin.