First, in our analysis, the positive rate of SARS-CoV-2-specific antibody detection was higher than that of RT-PCR detection (81% vs 37%). length of hospital stay was 10.66 days and 74% had admitted to accept intensive care. Conclusions Our study documented three common types of PMIS clinical presentation: persistent fever and gastrointestinal symptoms, shocked with heart dysfunction and Kawasaki disease-like syndrome. PMIS patients proved with a marked inflammatory state were possibly associated with SARS-CoV-2 contamination. strong class=”kwd-title” Keywords: Pediatric Multi-system Inflammatory Syndrome, SARS-CoV-2, COVID-19 Background The early situation of coronavirus disease 2019 (COVID-19) seemed to appear milder symptoms and lower fatality on more youthful patients (Juan et al., 2020, Tagarro et al., 2020, Zheng et al., 2020). As the pandemic continues, clusters of children presented with harmful shock symptoms and incomplete Kawasaki features were observed across Europe and the United States (Belhadjer et al., 2020, Riphagen et al., YL-0919 2020, Toubiana et al., 2020a, 2020). This novel syndrome was named pediatric multi-system inflammatory syndrome (PMIS) or multisystem inflammatory syndrome in children (MIS-C). There are numerous organizations like the World Health Business (WHO), US Centers for Disease Control and Prevention (CDC), the Royal College of Paediatrics and Child YL-0919 Health (RCPCH) and the European Centre for Disease Prevention and Control, have defined and created criteria for this child years inflammatory disorder as the COVID-19 pandemic was rampant over numerous countries (Whittaker et al., 2020). Since then, PMIS has been reported in New York, Paris and San Diego (Belhadjer et al., 2020, Toubiana et al., 2020a, Toubiana et al., 2020b, Whittaker et al., 2020). However, as the diagnostic criteria has not been Arnt unified, misdiagnosis and missed diagnosis still remain possible, in the mean time unclear definitions could bring confusion and hard management. Additionally, molecular evidence in pathogenesis remains highly insufficient in this recent onset YL-0919 of COVID-19 pediatric complication. To address the above-mentioned questions, we aim to collect current evidence on pediatric PMIS and provide insights into pathogenesis, hopefully, providing possible clues for further research and treatment at this moment. Methods We conducted a systematic literature search in PubMed and Embase according to the following terms: coronavirus or COVID-19 or 2019-nCoV or SARS-CoV-2 and Pediatric Multi-system Inflammatory Syndrome or Kawasaki-like disease. Since PMIS was recognized in May 2020, the time period was restricted to but not included the literature published prior to this time point. Available full texts and reference lists of relevant studies were examined. There was no language restriction to our research. The last update of the study was on June 24th, 2020. Inclusion and exclusion criteria There were two impartial reviewers (Hua Zou, Juan Lu) screened all titles and abstracts in term of eligibility. Studies are eligible for inclusion if they met the following criteria: 1) patients were less than 18 years old, 2) patients with elevated inflammatory markers, 3) patients with no other obvious microbial causes of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes. We excluded the following criterion: editorials, correspondence letters, review, qualitative studies and non-full text articles. Data collection and quality assessment After full-text screening of eligibility and evaluate, there were three authors (Jingjing Liu, Josiah Hiu-yuen Wong, Chunli Li) extracted data solely. The following items were extracted from each study, including: author, journal, date of publication, study design, country, contact or travel history, clinical symptoms, laboratory results and prognosis. The quality of studies offered in meta-analysis was assessed by the Newcastle-Ottawa Level (NOS). Articles at poor quality (score Z 0-3) were excluded. Data synthesis and analysis We offered the data with descriptive statistics and pooled available data for overall demonstration. Stata 15.0 was utilized for meta-analysis and drawing graph, YL-0919 and Q test YL-0919 was used to evaluate heterogeneity. If P 0.1.