Ahmed Mubbasheer, Advani Shailesh, Moreira Axel, Zoretic Sarah, Martinez John, Chorath Kevin, Acosta Sebastian, Naqvi Rija, Burmeister-Morton Finn, Burmeister Fiona, Tarriela Aina, Petershack Matthew, Evans Mary, Hoang Ansel, Rajasekaran Karthik, Ahuja Sunil, Moreira Alvaro
Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA.
Department of Oncology, Georgetown University, Washington, DC, USA.
EClinicalMedicine. 2020 Sep;26:100527. doi: 10.1016/j.eclinm.2020.100527. Epub 2020 Sep 4.
Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 (COVID-19). We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition.
We conducted a systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C. We searched four medical databases to encompass studies characterizing MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors screened articles, extracted data, and assessed risk of bias. This review was registered with PROSPERO CRD42020191515.
Our search yielded 39 observational studies ( = 662 patients). While 71·0% of children ( = 470) were admitted to the intensive care unit, only 11 deaths (1·7%) were reported. Average length of hospital stay was 7·9 ± 0·6 days. Fever (100%, = 662), abdominal pain or diarrhea (73·7%, = 488), and vomiting (68·3%, = 452) were the most common clinical presentation. Serum inflammatory, coagulative, and cardiac markers were considerably abnormal. Mechanical ventilation and extracorporeal membrane oxygenation were necessary in 22·2% ( = 147) and 4·4% ( = 29) of patients, respectively. An abnormal echocardiograph was observed in 314 of 581 individuals (54·0%) with depressed ejection fraction (45·1%, = 262 of 581) comprising the most common aberrancy.
Multisystem inflammatory syndrome is a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown.
Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study.
儿童多系统炎症综合征（MIS-C），也称为儿童炎症性多系统综合征，是一种新出现的危险的儿童疾病，与2019冠状病毒病（COVID-19）在时间上相关。我们旨在描述被诊断患有这种高炎症状态的儿童的典型表现和预后。
我们进行了一项系统评价，以交流MIS-C患者的临床体征和症状、实验室检查结果、影像学结果及预后。我们检索了四个医学数据库，纳入2020年1月1日至2020年7月25日期间描述MIS-C的研究。两名独立作者筛选文章、提取数据并评估偏倚风险。本评价已在PROSPERO注册，注册号为CRD42020191515。
我们的检索共获得39项观察性研究（n = 662例患者）。虽然71.0%的儿童（n = 470）入住了重症监护病房，但仅报告了11例死亡（1.7%）。平均住院时间为7.9±0.6天。发热（100%，n = 662）、腹痛或腹泻（73.7%，n = 488）以及呕吐（68.3%，n = 452）是最常见的临床表现。血清炎症、凝血和心脏标志物明显异常。分别有22.2%（n = 147）和4.4%（n = 29）的患者需要机械通气和体外膜肺氧合。581例患者中有314例（54.0%）超声心动图异常，射血分数降低者最为常见（45.1%，n = 581例中的262例）。
多系统炎症综合征是一种与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）相关的新的儿科疾病，危险且有潜在致命性。通过及时识别和医疗关注，大多数儿童能够存活，但目前尚不清楚这种疾病的长期预后。
帕克·B·弗朗西斯基金以及2R25-HL126140的试点资助。资助机构未参与本研究。
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