Division of Pediatric Rheumatology, Children's Hospital at Montefiore, The University Hospital for Albert Einstein College of Medicine, New York, USA.
Curr Opin Rheumatol. 2021 Sep 1;33(5):446-452. doi: 10.1097/BOR.0000000000000814.
The purpose of this review is to discuss the clinical management of children with pediatric rheumatic disease (PRD) during the Coronavirus disease of 2019 (COVID-19) pandemic, as well as the unique role of the pediatric rheumatologist during a time of emerging post-COVID inflammatory sequelae including, multisystem inflammatory syndrome in children (MIS-C).
To date, there has been little evidence to suggest that children with PRD, including those on immunomodulatory therapies, are at increased risk for severe COVID-19. Clinical guidance statements have been created to support clinical providers in providing care to children with PRD during the COVID-19 pandemic. Pediatric rheumatologists have also been called upon to assist in the identification and management of post-COVID sequelae, including the rapidly emerging inflammatory illness, MIS-C.
The COVID-19 era has been defined by a rapid expansion in scientific knowledge and a time of extraordinary local and worldwide collaboration, both within the pediatric rheumatology community, as well as across multiple disciplines. Through collective efforts, we have learned that children with PRD, including those on immunomodulatory therapies, are not at increased risk for severe COVID-19. Pediatric rheumatologists have also worked alongside other disciplines to develop guidance for the management of MIS-C, with the majority of patients experiencing excellent clinical outcomes.
本文旨在讨论儿童风湿性疾病(PRD)患儿在 2019 年冠状病毒病(COVID-19)大流行期间的临床管理,以及在新兴的 COVID-19 后炎症后遗症(包括儿童多系统炎症综合征,MIS-C)时期,儿科风湿病医生的独特作用。
迄今为止,几乎没有证据表明 PRD 患儿(包括接受免疫调节治疗的患儿)患 COVID-19 重症的风险增加。已制定临床指南,以支持临床医生在 COVID-19 大流行期间为 PRD 患儿提供护理。儿科风湿病医生也被要求协助识别和管理 COVID-19 后遗症,包括迅速出现的炎症性疾病 MIS-C。
COVID-19 时代的特点是科学知识迅速扩展,以及本地和全球范围内的协作,无论是在儿科风湿病学领域内,还是在多个学科之间,都达到了前所未有的程度。通过共同努力,我们了解到 PRD 患儿(包括接受免疫调节治疗的患儿)患 COVID-19 重症的风险并未增加。儿科风湿病医生还与其他学科合作,制定了 MIS-C 的管理指南,大多数患者的临床结局良好。