Atay Gurkan, Hasbal Canan, Türk Mücahit, Erdoğan Seher, Sözeri Betül
Department of Pediatric Critical Care, Health Science University, Ümraniye Research and Training Hospital, İstanbul 34760, Turkey.
Department of Pediatrics, Health Science University, Ümraniye Training and Research Hospital, Istanbul 34760, Turkey.
Children (Basel). 2021 Jun 11;8(6):498. doi: 10.3390/children8060498.
Multisystemic inflammatory syndrome in children (MIS-C) is a new potentially life-threatening disease that is related to coronavirus disease 2019 (COVID-19). The aim of this study is to reveal the clinical and laboratory results of MIS-C and the role of therapeutic plasma exchange (TPE) in its treatment. Clinical, laboratory and radiological characteristics of the patients who were admitted to the pediatric ward and pediatric intensive care unit (PICU) of a tertiary hospital with a diagnosis of MIS-C between April 2020 and March 2021 were included in the study. Forty-one patients were admitted to our hospital with a diagnosis of MIS-C. Twenty-one (51.2%) patients were admitted to the PICU. Six patients needed invasive mechanical ventilation (14.6%), 10 patients (24.4%) TPE and 3 patients (7.3%) needed extracorporeal membrane oxygenation (ECMO). The patients were grouped according to need for PICU admission (Group 1: no need for PICU, Group 2: need for PICU admission). Group 2 had significantly higher levels of C-reactive protein (CRP), alanine aminotransferase (ALT), ferritin, D-dimer, pro-B type natriuretic peptide (pro BNP) and lactate ( < 0.05). Hyponatremia found to be an independent risk factor for inpatient MIS-C in the PICU. We think that dynamic laboratory trending is beneficial in determining the need for PICU admission and TPE may be effective in critically ill patients.
儿童多系统炎症综合征（MIS-C）是一种与2019冠状病毒病（COVID-19）相关的新型潜在危及生命的疾病。本研究的目的是揭示MIS-C的临床和实验室结果以及治疗性血浆置换（TPE）在其治疗中的作用。本研究纳入了2020年4月至2021年3月期间在一家三级医院儿科病房和儿科重症监护病房（PICU）确诊为MIS-C的患者的临床、实验室和放射学特征。41例患者因MIS-C诊断入住我院。21例（51.2%）患者入住PICU。6例患者需要有创机械通气（14.6%），10例患者（24.4%）需要TPE，3例患者（7.3%）需要体外膜肺氧合（ECMO）。根据是否需要入住PICU将患者分组（第1组：不需要入住PICU，第2组：需要入住PICU）。第2组患者的C反应蛋白（CRP）、丙氨酸转氨酶（ALT）、铁蛋白、D-二聚体、B型脑钠肽前体（pro BNP）和乳酸水平显著更高（<0.05）。低钠血症被发现是PICU中住院MIS-C患者的独立危险因素。我们认为动态实验室趋势有助于确定是否需要入住PICU，并且TPE可能对危重症患者有效。
