比较 COVID-19 相关登革热和儿童多系统炎症综合征（MIS-C）的临床特征和结局。
Comparison of Clinical Features and Outcome of Dengue Fever and Multisystem Inflammatory Syndrome in Children Associated With COVID-19 (MIS-C).
机构信息
Department of Paediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab. Correspondence to: Dr Gurdeep Singh Dhooria, Professor, Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab.
Department of Paediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab.
出版信息
Indian Pediatr. 2021 Oct 15;58(10):951-954. doi: 10.1007/s13312-021-2329-9. Epub 2021 Jul 23.
OBJECTIVE
To identify clinical and laboratory features that differentiate dengue fever patients from MIS-C patients and determine their outcomes.
METHODS
This comparative cross-sectional study was done at a tertiary care teaching institute. We enrolled all hospitalized children aged 1 month - 18 years and diagnosed with either MIS-C and/or dengue fever according to WHO criteria between June and December, 2020. Clinical and laboratory features and outcomes were recorded on a structured proforma.
RESULTS
During the study period 34 cases of MIS-C and 83 cases of Dengue fever were enrolled. Mean age of MIS-C cases (male, 86.3%) was 7.89 (4.61) years. MIS-C with shock was seen in 15 cases (44%), MIS-C without shock in 17 cases (50%) and Kawasaki disease-like presentation in 2 cases (6%). Patients of MIS-C were younger as compared to dengue fever (P=0.002). Abdominal pain and erythematous rash were more common in dengue fever. Of the inflammatory markers, mean C reactive protein was higher in MIS-C patients [100.2 (85.1) vs 16.9 (29.3) mg/dL] (P<0.001). In contrast, serum ferritin levels were higher in dengue fever patients (P=0.03). Mean hospital stay (patient days) was longer in MIS- C compared to dengue fever (8.6 vs 6.5 days; P=0.014).
CONCLUSION
Clinical and laboratory features can give important clues to differentiate dengue fever and MIS-C and help initiate specific treatment.
目的
确定能够区分登革热患者和 MIS-C 患者的临床和实验室特征，并评估其结局。
方法
这是一项在一家三级教学医院进行的比较性横断面研究。我们招募了所有在 2020 年 6 月至 12 月期间根据世界卫生组织标准诊断为 MIS-C 和/或登革热的住院 1 个月至 18 岁的儿童。记录了临床和实验室特征及结局。
结果
研究期间共纳入了 34 例 MIS-C 和 83 例登革热病例。MIS-C 组病例的平均年龄（男性占 86.3%）为 7.89（4.61）岁。15 例（44%）MIS-C 伴有休克，17 例（50%）MIS-C 无休克，2 例（6%）为川崎病样表现。MIS-C 患者的年龄明显小于登革热患者（P=0.002）。腹痛和出疹更常见于登革热。在炎症标志物方面，MIS-C 患者的平均 C 反应蛋白更高[100.2（85.1）vs 16.9（29.3）mg/dL]（P<0.001）。相比之下，登革热患者的血清铁蛋白水平更高（P=0.03）。MIS-C 的住院时间（患者天数）明显长于登革热（8.6 天 vs 6.5 天；P=0.014）。
结论
临床和实验室特征可以提供重要线索，帮助区分登革热和 MIS-C，并有助于启动特定的治疗。
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