Paediatric Multisystem Inflammatory Syndrome Associated with COVID-19: Advances, Controversies, and Future Perspectives

Paediatric multisystem inflammatory syndrome (MIS-C), temporally linked to SARS-CoV-2 infection, emerged in 2020 as a condition of significant clinical concern due to its potential to cause multiorgan dysfunction and severe outcomes. It is a post-infectious phenomenon characterised by a dysregulated immune response and intense systemic inflammation. This review analyses scientific findings from the past decade, with emphasis on advances in pathophysiology, updated diagnostic criteria, epidemiological changes over the course of the pandemic, diversity of clinical manifestations, therapeutic strategies, and future perspectives. In 2020, the first cases of MIS-C were diagnosed as Kawasaki disease, and after changes, like Kawasaki disease. The documented experience of a second-level hospital in Guanajuato, Mexico, is also incorporated, allowing reflection on diagnostic and therapeutic challenges in middle-resource settings. Although incidence has decreased following the circulation of recent variants and the implementation of vaccination, MIS-C continues to represent a challenge for global paediatrics.