Carbajal Ricardo, Lorrot Mathie, Levy Yael, Grimprel Emmanuel, Lecarpentier Thibault, Heritier Sebastien, Faivre Judith, Schnuriger Aurélie, Parisot Pauline, Blondiaux Eléonore, Loschi Solene, Rivière Simon, Guilbert Julia, Romain Anne-Sophie, Leger Pierre-Louis, Guedj Romain
Pediatric Emergency Department, APHP Hôpital Armand Trousseau - Sorbonne Université, INSERM UMR1153, Paris, France.
General Pediatrics Department, APHP Hôpital Armand Trousseau - Sorbonne Université, Paris, France.
Acta Paediatr. 2021 Mar;110(3):922-932. doi: 10.1111/apa.15667. Epub 2020 Dec 21.
This study determined the influence of the COVID-19 pandemic on the occurrence of multisystem inflammatory syndrome in children (MIS-C) and compared the main characteristics of MIS-C and Kawasaki disease (KD).
We included patients aged up to 18 years of age who were diagnosed with MIS-C or KD in a paediatric university hospital in Paris from 1 January 2018 to 15 July 2020. Clinical, laboratory and imaging characteristics were compared, and new French COVID-19 cases were correlated with MIS-C cases in our hospital.
There were seven children with MIS-C, from 6 months to 12 years of age, who were all positive for the virus that causes COVID-19, and 40 virus-negative children with KD. Their respective characteristics were as follows: under 5 years of age (14.3% vs. 85.0%), paediatric intensive care unit admission (100% vs. 10.0%), abdominal pain (71.4% vs. 12.5%), myocardial dysfunction (85.7% vs. 5.0%), shock syndrome (85.7% vs. 2.5%) and mean and standard deviation C-reactive protein (339 ± 131 vs. 153 ± 87). There was a strong lagged correlation between the rise and fall in MIS-C patients and COVID-19 cases.
The rise and fall of COVID-19 first wave mirrored the MIS-C cases. There were important differences between MIS-C and KD.
本研究确定了新冠疫情对儿童多系统炎症综合征(MIS-C)发病情况的影响,并比较了MIS-C与川崎病(KD)的主要特征。
我们纳入了2018年1月1日至2020年7月15日期间在巴黎一家儿科大学医院被诊断为MIS-C或KD的18岁及以下患者。比较了临床、实验室和影像学特征,并将我院新的新冠病例与MIS-C病例进行了关联分析。
有7名年龄在6个月至12岁之间的MIS-C患儿,其新冠病毒检测均呈阳性,还有40名病毒检测阴性的KD患儿。他们各自的特征如下:5岁以下(14.3%对85.0%)、入住儿科重症监护病房(100%对10.0%)、腹痛(71.4%对12.5%)、心肌功能障碍(85.7%对5.0%)、休克综合征(85.7%对2.5%)以及C反应蛋白的平均值和标准差(339±131对153±87)。MIS-C患者的增减与新冠病例之间存在很强的滞后相关性。
新冠疫情第一波的起伏反映了MIS-C病例的情况。MIS-C和KD之间存在重要差异。