Henrina Joshua, Putra Iwan Cahyo Santosa, Lawrensia Sherly, Marta Della Sabrina, Wijaya Ellen, Saboe Aninka, Cool Charlotte Johanna, Suciadi Leonardo Paskah
Siloam Heart Institute, Jakarta, Indonesia.
Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
Prog Pediatr Cardiol. 2021 Dec;63:101365. doi: 10.1016/j.ppedcard.2021.101365. Epub 2021 Feb 9.
Paediatric inflammatory multisystem syndrome (PIMS) temporally associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (PIMS-TS) is a rare clinical syndrome associated with a multiorgan system dysfunction, especially acute cardiac injury, and mandates a higher level of care.
To investigate cardiac manifestations, treatment characteristics, and outcomes of PIMS-TS.
Twenty-six studies were included with 1228 pooled subjects, with a mean age of 8.6 years, which were dominated by male gender (53%), and African ethnicity (31%). 732 (38%) patients were reactive on a serological test, and 457 patients (45%) were positive on SARS-CoV-2 RT-PCR. ST-segment abnormalities were the most common ECG findings (16%, n/N: 34/212). Various markers of troponin and the pooled mean of BNP and NT-pro-BNP levels were elevated. Cardiomegaly and pericardial effusion (21.8%, n/N: 164/751) were the most common chest X-ray findings. In echocardiography, the majority of patients' left ventricular ejection fraction was reduced (59.0%, n/N: 180/305), with pericardial effusion/ pericarditis seen the most (17.44%, n/N: 221/1267), and Z score ≥ 2 in 28% (n/N: 42/139). Cardiac MRI findings were consistent with acute myocarditis. Intravenous immunoglobulin, corticosteroids, and vasoactive drugs were frequently utilized. The mean length of stay was 6 days, with most patients (71%, n/N: 834/1163) were admitted to the ICU. However, the overall prognosis was favorable, with 98% alive (n/N: 1235/1260), and more than 50% of patients experienced recovery of left ventricular systolic functions at discharge (116 out of 206 patients).
与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在时间上相关的儿童炎症性多系统综合征（PIMS）（PIMS-TS）是一种罕见的临床综合征，与多器官系统功能障碍相关，尤其是急性心脏损伤，需要更高水平的护理。
研究PIMS-TS的心脏表现、治疗特点和预后。
纳入了26项研究，共1228名受试者，平均年龄8.6岁，以男性（53%）和非洲裔（31%）为主。732名（38%）患者血清学检测呈反应性，457名患者（45%）SARS-CoV-2逆转录聚合酶链反应（RT-PCR）呈阳性。ST段异常是最常见的心电图表现（16%，n/N：34/212）。肌钙蛋白的各种标志物以及脑钠肽（BNP）和N末端脑钠肽原（NT-pro-BNP）水平的合并平均值升高。心脏扩大和心包积液（21.8%，n/N：164/751）是最常见的胸部X线表现。在超声心动图检查中，大多数患者的左心室射血分数降低（59.0%，n/N：180/305），心包积液/心包炎最为常见（17.44%，n/N：221/1267），28%（n/N：42/139）的患者Z评分≥2。心脏磁共振成像（MRI）结果与急性心肌炎一致。静脉注射免疫球蛋白、皮质类固醇和血管活性药物被频繁使用。平均住院时间为6天，大多数患者（71%，n/N：834/1163）入住重症监护病房（ICU）。然而，总体预后良好，98%存活（n/N：1235/1260），超过50%的患者出院时左心室收缩功能恢复（206名患者中有116名）。
