Department of Laboratory Medicine, Chongqing Health Center for Women and Children, 120 Longshan road, Yubei District, Chongqing 400016, China.
Department of Otolaryngology, Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Int J Infect Dis. 2021 Jan;102:319-326. doi: 10.1016/j.ijid.2020.11.145. Epub 2020 Nov 14.
There was an outbreak of pediatric multisystem inflammation syndrome (PMIS) was observed in multiple countries recently, and this syndrome was suspected to be associated with SARS-CoV-2 infection. At present, there is still no standardized diagnostic criteria and treatment regimen for PMIS, while the etiology and pathogenesis still remain unclear.
We performed a systematic review on PubMed and Embase from the time of inception to June 24th 2020 in order to find relevant cases.
There are seven studies included, and 80% of patients suffered persistent fever and 90% appeared gastrointestinal symptoms. IgG antibody against SARS-CoV-2 was positive on 81% of patients, while 37% of the patients were nucleic acid positive. C-reactive protein, IL-6 and PCT were elevated and intravenous immunoglobulin was a routine treatment for PMIS. There were more than half of patients required inotropic supports and mechanical ventilation were applied to 33% of patients. The median length of hospital stay was 10.66 days and 74% had admitted to accept intensive care.
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 infection.
最近多个国家观察到小儿多系统炎症综合征（PMIS）的爆发，该综合征疑似与 SARS-CoV-2 感染有关。目前，PMIS 尚无标准化的诊断标准和治疗方案，其病因和发病机制仍不清楚。
我们对从创建到 2020 年 6 月 24 日在 PubMed 和 Embase 上进行了系统回顾，以寻找相关病例。
共纳入 7 项研究，80%的患者持续发热，90%的患者出现胃肠道症状。81%的患者 SARS-CoV-2 抗体 IgG 阳性，37%的患者核酸阳性。C 反应蛋白、IL-6 和 PCT 升高，静脉注射免疫球蛋白是 PMIS 的常规治疗方法。超过一半的患者需要正性肌力支持，33%的患者需要机械通气。中位住院时间为 10.66 天，74%的患者接受重症监护。
本研究记录了 PMIS 的三种常见临床表现类型：持续发热和胃肠道症状、伴有心功能障碍的休克和川崎病样综合征。PMIS 患者表现出明显的炎症状态，可能与 SARS-CoV-2 感染有关。
