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Head and Neck Surgery

Otolaryngologic Manifestations in Pediatric Inflammatory Multisystem Syndrome Temporally Associated With COVID-19

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Otolaryngology–Head & Neck Surgery

Published Online: February 25, 2021

Research Letter

Article Information and Disclosures

Ryan C. T. Cheong, BSc(Hons), MBBS¹;

Christopher Jephson, MBBS¹;

Claire Frauenfelder, MBBS, MSurg¹;

Lesley Cavalli, BSc(Hons), MSc, MRCSLT²;

Karyn Moshal, MBChB, DTM&H³;

Colin R. Butler, PhD, MBBS^1,4;

Michelle E. Wyatt, MA(Cantab), MBBS(Cantab)¹

Author Affiliations

¹Ear, Nose and Throat Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
²Speech and Language Therapy Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
³Infectious Disease Department, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
⁴Stem Cell and Regenerative Medicine Division, Institute of Child Health UCL, London, United Kingdom

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Original Investigation

Association of IVIG Plus Methylprednisolone With Persistent or Recurrent Fever in Children With MIS-C

Naïm Ouldali, MD, PhD; Julie Toubiana, MD, PhD; Denise Antona, MD; Etienne Javouhey, MD, PhD; Fouad Madhi, MD; Mathie Lorrot, MD, PhD; Pierre-Louis Léger, MD, PhD; Caroline Galeotti, MD, PhD; Caroline Claude, MD; Arnaud Wiedemann, MD, PhD; Noémie Lachaume, MD; Caroline Ovaert, MD, PhD; Morgane Dumortier, MD; Jean-Emmanuel Kahn, MD, PhD; Alexis Mandelcwajg, MD; Lucas Percheron, MD; Blandine Biot, MD; Jeanne Bordet, MD; Marie-Laure Girardin, MD; David Dawei Yang, MD; Marion Grimaud, MD; Mehdi Oualha, MD, PhD; Slimane Allali, MD, PhD; Fanny Bajolle, MD; Constance Beyler, MD; Ulrich Meinzer, MD, PhD; Michael Levy, MD, PhD; Ana-Maria Paulet, MD; Corinne Levy, MD; Robert Cohen, MD; Alexandre Belot, MD, PhD; François Angoulvant, MD, PhD; French Covid-19 Paediatric Inflammation Consortium; Cinthia Rames; Aurelie Donzeau; Sophie Lety; Cristian Fedorczuk; Marion Lajus; Philippe Bensaid; Yacine Laoudi; Charlotte Pons; Camille Beaucourt; Loïc De Pontual; Camille Aupiais; Alain Lefevre-Utile; Muriel Richard; Etienne Goisque; Xavier Iriart; Olivier Brissaud; Marion Bailhache; Pierre Segretin; Julie Molimard; Marie-Clothilde Orcel; Gregoire Benoist; Elsa Amouyal; Margaux Guerder; Robin Pouyau; Jean-Marie De Guillebon De Resnes; Ellia Mezgueldi; Fleur Cour-Andlauer; Come Horvat; Pierre Poinsot; Cecile Frachette; Antoine Ouziel; Yves Gillet; Catherine Barrey; Jacques Brouard; Caroline Faucon; Henri Ginies; Vathanaksambath Ro; Narcisse Elanga; Vincent Gajdos; Romain Basmaci; Nevena Danekova; Hadile Mutar; Sébastien Rouget; Xavier Torterüe; Elodie Nattes; Isabelle Hau; Sandra Biscardi; Houmam El Jurdi; Camille Jung; Ralph Epaud; Céline Delestrain; Adèle Carlier-Gonod; Camille Chavy; Benoît Colomb; Stéphanie Litzler-Renault; Denis Semama; Frederic Huet; Mayssa Sarakbi; Guillaume Mortamet; Cécile Bost-Bru; Charlotte Kevorkian-Verguet; Matthias Lachaud; Caroline Vinit; Véronique Hentgen; Pascal Leroux; Valérie Bertrand; Caroline Parrod; Irina Craiu; Isabelle Kone-Paut; Philippe Durand; Pierre Tissiere; Luc Morin; Jordi Miatello; Guillaume Morelle; Tamazoust Guiddir; Charlotte Borocco; Camille Guillot; Stéphane Leteurtre; François Dubos; Mylene Jouancastay; Morgan Recher; Alain Martinot; Valentine Voeusler; Jeanne Languepin; Aurélie Morand; Emmanuelle Bosdure; Violaine Bresson; Noémie Vanel; Fabrice Ughetto; Fabrice Michel; Caujolle Marie; Renaud Blonde; Jacqueline Nguyen; Nathalie Garrec; Arnaud Chalvon-Demersay; Caroline Masserot-Lureau; Anne-Sophie Colas; Claire Ferrua; Anis Larakeb; Sakina Benkaddouss; Laurence Mathivon; Marie Monfort; Sanaa Naji; Aurelia Carbasse; Christophe Milesi; Cyril Schweitzer; Nathan Giroux; Noël Boussard; Benedicte Romefort; Elise Launay; Christèle Gras-Le Guen; Ahmed Ali; Nathalie Blot; Antoine Tran; Anne Rancurel; Hervé Haas; Mickael Afanetti; Julie Bernardor; Deborah Talmud; Imen Jhaouat; Françoise Monceaux; Anaïs Chosidow; Anne-Sophie Romain; Emmanuel Grimprel; Jérôme Rambaud; Sandrine Jean; Julie Starck; Yaël Levy; Romain Guedj; Ricardo Carbajal; Pauline Parisot; Géraldine Poncelet; Richard Wolff; Boris Lacarra; Arielle Maroni; Jérôme Naudin; Guillaume Geslin; Laure Maurice; Anna Deho; Fleur Lebourgeois; Marilyne Chomton; Stephane Dauger; Mathieu Genuini; Chérine Benzouid; Johanna Lokmer; Ronan Bonnefoy; Isabelle Melki; Glory Dingulu; Jean Gaschignard; Camille Ducrocq; Marie Pouletty; Olivier Corseri; Albert Faye; Alexis Rybak; Luigi Titomanlio; Marie-Françoise Hurtaux; Guislaine Garcelain; Stéphane Bonacorsi; Philippe Bidet; André Birgy; Sylvain Renolleau; Fabrice Lesage; Florence Moulin; Laurent Dupic; Laure de Saint Blanquat; Claire Heilbronner; Meryl Vedrenne-Cloquet; Elodie Salvador; Matthieu Bendavid; Charles De Marcellus; Judith Chareyre; Yael Pinhas; Joséphine Brisse; Melissa Taylor; Agathe Debray,; Pauline Adnot; Martin Chalumeau; Véronique Abadie; Pierre Frange; Jeremie F Cohen; William Curtis; Hélène Chappuy; Zahra Belhadjer; Johanne Auriau; Mathilde Méot; Lucile Houyel; Damien Bonnet; Christophe Delacourt; David Drummond; Brigitte Bader-Meunier; Pierre Quartier; Frédérique Delion; Philippe Blanc; Elisabeth Caron; Natacha Maledon; Blandine Robert; Letitia Pantalone; Hanane Kouider; Camille Loeile; Gauthier Loron; Cécile Vittot; Thierry Blanc; Didier Pinquier; François Buisson; Hugues Flodrops; Jamal-Bey Karim; Raphaëlle Sarton; Fadhila Mokraoui; Simon Escoda; Nina Deschamps; Laurent Bonnemains; Sarah-Louisa Mahi; Clara Mertes; Joelle Terzic; Charlotte Idier; Ariane Benezech; Thomas Simon; Stephane Decramer; Clement Karsenty; Camille Brehin; Soraya Chenichene; Nicoleta-Magdolena Ursulescu; Céline Manteau; Marie Delattre; Bérengère Dalichoux

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As a consequence of increasing reports of an unusual and novel presentation of a multisystem inflammatory disease in the UK, the Royal College of Paediatrics and Child Health published a case definition on May 1, 2020, of pediatric inflammatory multisystem syndrome temporally associated with coronavirus disease 2019 (COVID-19) (PIMS-TS).¹ They defined PIMS-TS as persistent fever, inflammation, and evidence of single or multiorgan dysfunction, with exclusion of any other microbial cause and with positive or negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction test results. In the US, this condition has been defined by the Centers for Disease Control and Prevention as multisystem inflammatory syndrome in children, with a more specific case definition.²

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Article Information

Accepted for Publication: December 20, 2020.

Published Online: February 25, 2021. doi:10.1001/jamaoto.2020.5698

Corresponding Author: Ryan C. T. Cheong, BSc(Hons), MBBS, Ear, Nose and Throat Department, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, United Kingdom (ryan.cheong@nhs.net).

Author Contributions: Mr Cheong had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Cheong, Frauenfelder, Moshal, Butler, Wyatt.

Acquisition, analysis, or interpretation of data: Cheong, Jephson, Frauenfelder, Cavalli, Butler, Wyatt.

Drafting of the manuscript: Cheong, Frauenfelder, Wyatt.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Cheong.

Administrative, technical, or material support: Cheong, Frauenfelder, Moshal, Wyatt.

Supervision: Cheong, Jephson, Cavalli, Moshal, Butler, Wyatt.

Conflict of Interest Disclosures: None reported.

Additional Contributions: Delane Shingadia, MBChB, DCH, DTM&H, MPH, provided editing assistance; Justin Penner, MD, MSc, DTM&H, assisted in data collection and analysis; and Karlie Grant, BN, assisted in data collection; all with Great Ormond Street Hospital for Children NHS Trust.

References

Royal College of Paediatrics and Child Health. Guidance: Paediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19. Published 2020. Accessed August 11, 2020. https://www.rcpch.ac.uk/sites/default/files/2020-05/COVID-19-Paediatric-multisystem-%20inflammatory%20syndrome-20200501.pdf

Centers for Disease Control and Prevention: Health Alert Network. Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19). Published May 2020. Accessed August 11, 2020. https://emergency.cdc.gov/han/2020/han00432.asp

Lechien JR , Chiesa-Estomba CM , Cabaraux P , et al. Features of mild-to-moderate COVID-19 patients with dysphonia. J Voice. Published online June 4, 2020. doi:10.1016/j.jvoice.2020.05.012 PubMed Google Scholar

Brann DH , Tsukahara T , Weinreb C , et al. Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. Sci Adv. 2020;6(31):1-20. doi:10.1126/sciadv.abc5801 PubMed Google Scholar Crossref

Frajkova Z , Tedla M , Tedlova E , Suchankova M , Geneid A . Postintubation dysphagia during COVID-19 outbreak—contemporary review. Dysphagia. 2020;35(4):549-557. doi:10.1007/s00455-020-10139-6 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.