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MISC-C Presentation/Pathophysiology Since April 2020, several cases of hyperinflammatory shock linked to COVID-19 in children have been reported

Furthermore, studies have reported an aberrant activation of NRF2, a key antioxidant transcription factor involved in the regulation of critical antioxidants including glutathione, SOD, and CAT, leading to reduced antioxidant capacity (Davinelli et al., 2025) In ASD children, the oxidative stress is not only higher, but it manifests in a complicated new pattern concerning different types of ROS and antioxidants (Hirayama et al., 2020)

Within these pathways, many cell cytokines, including those associated with inflammation, such as IL-1, IL-6, TNF-10, IL-22, and TNF-alpha, contribute to the anorexia of cancer patients [8, 9, 12]