From the Unidad de Cuidados Intensivos Pediátricos, Clínica Sanatorio Alemán y Hospital Guillermo Grant Benavente, Concepción, Chile.
Pediatr Emerg Care. 2021 Jan 1;37(1):44-47. doi: 10.1097/PEC.0000000000002306.
Pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS) is infrequent, but children might present as a life-threatening disease. In a systematic quantitative review, we analyzed 11 studies of PIMS-TS, including 468 children reported before July 1, 2020. We found a myriad of clinical features, but we were able to describe common characteristics: previously healthy school-aged children, persistent fever and gastrointestinal symptoms, lymphopenia, and high inflammatory markers. Clinical syndromes such as myocarditis and Kawasaki disease were present in only one third of cases each one. Pediatric intensive care unit admission was frequent, although length of stay was less than 1 week, and mortality was low. Most patients received immunoglobulin or steroids, although the level of evidence for that treatment is low. The PIMS-ST was recently described, and the detailed quantitative pooled data will increase clinicians' awareness, improve diagnosis, and promptly start treatment. This analysis also highlights the necessity of future collaborative studies, given the heterogeneous nature of the PIMS-TS.
儿童炎症性多系统综合征与严重急性呼吸综合征冠状病毒 2(PIMS-TS)相关,较为罕见,但儿童可能会出现危及生命的疾病。在一项系统的定量综述中,我们分析了 11 项 PIMS-TS 研究,包括截至 2020 年 7 月 1 日报告的 468 名儿童。我们发现了许多临床特征,但能够描述常见特征:既往健康的学龄儿童,持续发热和胃肠道症状,淋巴细胞减少和高炎症标志物。每种临床综合征(如心肌炎和川崎病)的发生率均为三分之一。小儿重症监护病房的入院率较高,尽管住院时间不到 1 周,死亡率较低。大多数患者接受了免疫球蛋白或类固醇治疗,尽管这种治疗的证据水平较低。最近描述了 PIMS-ST,详细的定量汇总数据将提高临床医生的认识,改善诊断,并及时开始治疗。鉴于 PIMS-TS 的异质性,该分析还强调了未来合作研究的必要性。