Wang Ji-Gan, Zhong Zhi-Juan, Li Meng, Fu Jun, Su Yu-Heng, Ping You-Min, Xu Zi-Ji, Li Hao, Chen Yan-Hao, Huang Yu-Li
Pediatrics Department, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Pediatrics Department, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China.
Biochem Res Int. 2021 Jul 15;2021:5596727. doi: 10.1155/2021/5596727. eCollection 2021.
This study aimed to describe the clinical symptoms, laboratory findings, treatment, and outcomes of coronavirus disease 2019-related multisystem inflammatory syndrome in children to provide a reference for clinical practice.
We employed a literature search of databases such as PubMed, Web of Science, EMBASE, and Johns Hopkins University for articles on COVID-19-related multisystem inflammatory syndrome in children published between April 1, 2020, and January 15, 2021. High-quality articles were selected for analysis on the basis of their quality standard scores. Using R3.6.3 software, meta-analyses of random- or fixed-effects models were used to determine the prevalence of comorbidities. Subgroup analysis was also performed to determine heterogeneity.
A total of 57 articles (2,290 pediatric patients) were included in the study. . :ncidences of fever, gastrointestinal symptoms, respiratory symptoms, and musculoskeletal symptoms (myalgias or arthralgias) were 99.91% (95% CI: 99.67-100%), 82.72% (95% CI: 78.19-86.81%), 53.02% (45.28-60.68%), and 14.16% (95% CI: 8.4-21.12%), respectively. The incidences of rash, conjunctival injection, lymphadenopathy, dry cracked lips, neurologic symptoms (headache, altered mental status, or confusion), swollen hands and feet, typical Kawasaki disease, and atypical Kawasaki disease were 59.34% (95% CI: 54.73-63.87%), 55.23% (95% CI: 50.22-60.19%), 27.07% (95% CI: 19.87-34.93%), 46.37% (95% CI: 39.97-52.83%), 28.87% (95% CI: 22.76-35.40%), 28.75% (95% CI: 21.46-36.64%), 17.32% (95% CI: 15.44-19.29%), and 36.19% (95% CI: 21.90-51.86%), respectively. The incidences of coronary artery dilation, aneurysm, pericardial effusion, myocarditis, myocardial dysfunction, high troponin, and -terminal pro-B-type natriuretic peptide were 17.83%, 6.85%, 20.97%, 35.97%, 56.32%, 76.34%, and 86.65%, respectively. The incidences of reduced lymphocytes, thrombocytopenia, hypoalbuminemia, elevated C-reactive protein, ferritin, LDH, interleukin-6, PCT, and FIB were 61.51%, 26.42%, 77.92%, 98.5%, 86.79%, 80.59%, 89.30%, 85.10%, and 87.01%, respectively. . The incidences of PICU hospitalization or with shock were 72.79% and 55.68%, respectively. The mortality rate was 1.00%. . PICU hospitalization and shock rates of multisystem inflammatory syndrome in children associated with COVID-19 were high, and its cumulative multiorgans and inflammatory indicators are increased, but if treated in time, the mortality rate was low.
本研究旨在描述2019冠状病毒病相关儿童多系统炎症综合征的临床症状、实验室检查结果、治疗方法及预后，为临床实践提供参考。
我们在PubMed、Web of Science、EMBASE和约翰·霍普金斯大学等数据库中检索2020年4月1日至2021年1月15日发表的关于儿童COVID-19相关多系统炎症综合征的文章。根据质量标准评分选择高质量文章进行分析。使用R3.6.3软件，采用随机或固定效应模型进行荟萃分析以确定合并症的患病率。还进行了亚组分析以确定异质性。
本研究共纳入57篇文章（2290例儿科患者）。发热、胃肠道症状、呼吸道症状和肌肉骨骼症状（肌痛或关节痛）的发生率分别为99.91%（95%CI：99.67 - 100%）、82.72%（95%CI：78.19 - 86.81%）、53.02%（45.28 - 60.68%）和14.16%（95%CI：8.4 - 21.12%）。皮疹、结膜充血、淋巴结病、嘴唇干裂、神经系统症状（头痛、精神状态改变或意识模糊）、手足肿胀、典型川崎病和非典型川崎病的发生率分别为59.34%（95%CI：54.73 - 63.87%）、55.23%（95%CI：50.22 - 60.19%）、27.07%（95%CI：19.87 - 34.93%）、46.37%（95%CI：39.97 - 52.83%）、28.87%（95%CI：22.76 - 35.40%）、28.75%（95%CI：21.46 - 36.64%）、17.32%（95%CI：15.44 - 19.29%）和36.19%（95%CI：21.90 - 51.86%）。冠状动脉扩张、动脉瘤、心包积液、心肌炎、心肌功能障碍、高肌钙蛋白和N末端B型利钠肽原的发生率分别为17.83%、6.85%、20.97%、35.97%、56.32%、76.34%和86.65%。淋巴细胞减少、血小板减少、低白蛋白血症、C反应蛋白、铁蛋白、乳酸脱氢酶、白细胞介素 - 6、降钙素原和纤维蛋白原升高的发生率分别为61.51%、26.42%、77.92%、98.5%、86.79%、80.59%。入住儿科重症监护病房（PICU）或发生休克的发生率分别为72.79%和55.68%。死亡率为1.00%。与COVID - 19相关的儿童多系统炎症综合征的PICU住院率和休克率较高，其累积多器官及炎症指标升高，但及时治疗死亡率较低。
