儿童新型冠状病毒相关多系统炎症综合征(MIS-C):卡塔尔一家三级儿科医院的病例系列。

COVID-19 related multisystem inflammatory syndrome in children (MIS-C): a case series from a tertiary care pediatric hospital in Qatar.

机构信息

Sidra Medicine, PO BOX 26999, Doha, Qatar.

Weill Cornell Medical College in Qatar, Doha, Qatar.

出版信息

BMC Pediatr. 2021 Jun 8;21(1):267. doi: 10.1186/s12887-021-02743-8.

Abstract

BACKGROUND

Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication of coronavirus disease 2019 (COVID-19) in children, which is increasingly being reported worldwide. Here we report the first case series of 7 children diagnosed with MIS-C in Qatar.

METHODS

Clinical features and outcomes of COVID-19 positive patients admitted to Sidra Medicine, Qatar from June to October 2020, who met the WHO case definition for MIS-C were reviewed.

RESULTS

The mean age in our case series was 5.6 years, of which 71.4% were males. All patients were previously healthy but had a history of COVID-19 infection. Fever, rash, vomiting and abdominal pain were the most common symptoms (70-100%). The average hospitalization was 12.9 days with no case fatalities. Laboratory findings included lymphopenia and thrombocytopenia in most patients, as well as evidence of coagulopathy and elevated inflammatory markers such as C-reactive protein, ferritin and procalcitonin. Many patients (71.4%) required inotropic support in intensive care, while only one required respiratory support. Although all patients had elevated cardiac biomarkers, cardiovascular involvement was observed in 42.9% of patients with one patient developing a giant coronary aneurysm. All patients received intravenous immunoglobulin (IVIG) and 86% of patients received corticosteroids, with two patients requiring treatment with IL-1 inhibitors.

CONCLUSIONS

Our report is one of the first reports on MIS-C from Asia. Although clinical features and outcomes are not significantly different from those reported elsewhere, lack of case fatalities in our cohort may indicate that early recognition and prompt medical attention is necessary for a favorable outcome in MIS-C.

摘要

背景

儿童多系统炎症综合征(MIS-C)是儿童 2019 年冠状病毒病(COVID-19)的严重并发症,在世界范围内越来越多地报告。在这里,我们报告了卡塔尔首例 7 例确诊为 MIS-C 的儿童病例系列。

方法

对 2020 年 6 月至 10 月期间入住卡塔尔锡德拉医学中心的 COVID-19 阳性患者的临床特征和结局进行了回顾性分析,这些患者符合世界卫生组织(WHO)对 MIS-C 的病例定义。

结果

本病例系列的平均年龄为 5.6 岁,其中 71.4%为男性。所有患者既往均健康,但有 COVID-19 感染史。发热、皮疹、呕吐和腹痛是最常见的症状(70-100%)。平均住院时间为 12.9 天,无死亡病例。实验室检查结果显示,大多数患者存在淋巴细胞减少和血小板减少,以及凝血功能障碍和炎症标志物升高,如 C 反应蛋白、铁蛋白和降钙素原。许多患者(71.4%)在重症监护病房需要使用正性肌力药物支持,而只有 1 例需要呼吸支持。虽然所有患者的心脏生物标志物均升高,但仅 42.9%的患者观察到心血管受累,其中 1 例患者出现巨大冠状动脉瘤。所有患者均接受静脉注射免疫球蛋白(IVIG)治疗,86%的患者接受皮质类固醇治疗,其中 2 例患者需要白细胞介素-1 抑制剂治疗。

结论

本报告是亚洲首例关于 MIS-C 的报告之一。尽管临床特征和结局与其他地方报道的没有显著差异,但本队列中无死亡病例可能表明,早期识别和及时医疗干预对于 MIS-C 的良好结局是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f4b/8186178/091660373cec/12887_2021_2743_Fig1_HTML.jpg

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