儿童感染 SARS-CoV-2 相关多系统炎症综合征的临床特征。
Clinical Spectrum of Children With Multisystem Inflammatory Syndrome Associated With SARS-CoV-2 Infection.
机构信息
Pediatric Intensive Care Unit, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu.
Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, Tamil Nadu.
出版信息
Indian Pediatr. 2021 Oct 15;58(10):955-958. doi: 10.1007/s13312-021-2330-3. Epub 2021 Jun 28.
OBJECTIVES
To compare the clinical profile, treatment, and outcomes of PCR-positive and PCR-negative antibody-positive critically ill children with multisystem inflammatory syndrome (MIS-C).
METHODS
This retrospective observational study was done at a tertiary care coronavirus disease 19 (COVID-19) pediatric intensive care unit in India. The baseline characteristics, clinical profile, treatment, and outcomes in seventeen critically ill children diagnosed with MIS-C were analyzed from 1 July to 31 October, 2020.
RESULTS
Sixteen out of 17 children presented with hypotensive shock and respiratory distress. Mean (SD) age of PCR-negative antibody-positive and PCR-positive children was 11 (4.4) and 5 (3.7) years, respectively (P=0.007). The former group had significantly higher mean (SD) D-dimer levels [16,651 (14859) ng/mL vs 3082 (2591) ng/mL; P=0.02]. All received intensive care management and steroid therapy; 7 children received intravenous immunoglobulin. 14 children survived and 3 died.
CONCLUSIONS
The outcome of children with MIS-C was good if recognized early and received intensive care.
目的
比较聚合酶链反应（PCR）阳性和 PCR 阴性抗体阳性的危重症儿童多系统炎症综合征（MIS-C）的临床特征、治疗和结局。
方法
本回顾性观察研究在印度一家三级护理 2019 冠状病毒病（COVID-19）儿科重症监护病房进行。对 2020 年 7 月 1 日至 10 月 31 日期间确诊为 MIS-C 的 17 名危重症儿童的基线特征、临床特征、治疗和结局进行了分析。
结果
17 名儿童中有 16 名出现低血压性休克和呼吸窘迫。PCR 阴性抗体阳性和 PCR 阳性儿童的平均（SD）年龄分别为 11（4.4）岁和 5（3.7）岁（P=0.007）。前者的平均（SD）D-二聚体水平[16，651（14859）ng/ml 比 3082（2591）ng/ml；P=0.02]显著更高。所有患儿均接受重症监护管理和类固醇治疗；7 例患儿接受静脉注射免疫球蛋白治疗。14 例患儿存活，3 例患儿死亡。
结论
如果早期识别并接受重症监护，MIS-C 患儿的结局良好。
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